Dr Jainam Shah, Dr Amit Shah
Abstract: Here we report a case of a female who was diagnosed with acromegaly post-referral for prolonged postpartum amenorrhea. A 36-year-old female patient, gravida 2 para 1, had underwent normal transvaginal delivery and breastfeeding had been discontinued a year post delivery. Soon after, spontaneous menstruation failed to restart. Subsequently, she was referred to our general hospital for complain of prolonged amenorrhea with galactorrhoea and complains of enlarged tongue and lips. On hormonal investigation it was revealed that patient had severe hypogonadotropic hypogonadism (luteinizing hormone 1.23 mIU/mL, follicle-stimulating hormone 4.45 mIU/mL), along with a moderate increase in serum prolactin levels (53.2 ng/mL).Her growth hormone was 60 ng/ml. Magnetic resonance imaging (MRI) of the head was performed, to rule out organic abnormality in the central nervous system could be a cause of amenorrhea. MRI revealed mass lesions extending from the pituitary fossa to the suprasellar area with similar signal intensity as the gray matter. Bi-temporal hemianopsia was observed on campimetry. After brief examination, the patient was diagnosed with acromegaly.
Keywords: acromegaly, amenorrhea, postpartum