Q:

Does this patient require any other biochemical testing?

0

A 45-year-old lady presents with complaints of a progressive increase in the size of hands and feet and shoe size for past 5 years. The family members have noticed a change in her facial appearance in the form of coarsening of features and her voice has become sonorous. She also has complaints of frequent headaches for past 1 year. She complains of amenorrhea for past 5 years. She also has complaints of joint pains for past 3 years which have become more severe for the past 3 months. She is hypertensive for past 1 year and complaints of grade 2 dyspnea on exertion and her hypertension is controlled on 10 mg of cilnidipine and 40 mg of telmisartan. She is not a known diabetic and has checked her random sugars 1 week back which was normal. She is not on any other medications presently (Fig. 1.1).

Does this patient require any other biochemical testing?

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Further testing is needed to check for hypersecretion of prolactin and alson to check for any anterior and posterior pituitary hormones for any evidence of hypopituitarism. The patient is found to have secondary hypothyroidism and ACTH deficiency. Her prolactin levels are normal and her FSH, LH levels are normal. She is started on supplementation with levothyroxine and hydrocortisone.

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