ACROMEGALY ASSOCIATED WITH AMYOTROPHIC LATERAL SCLEROSIS AND ACROMEGALY OF THE AMYOTROPHIC TYPE REPORT OF 3 CASES

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Abstract
IT IS always intriguing to study the association of two diseases in which the cause of one is obscure. Under such circumstances ailments previously considered as separate entities have since been found to constitute a single disorder, thereby suggesting the cause and sometimes the cure for the disease. For example, the discovery of pituitary tumor led the way to our knowledge of the source of acromegaly and the development of much information concerning the endocrine control of growth. Generalized osteitis fibrosa cystica was described before it was known that the disease was associated with parathyroid tumors and, through the discovery of their association, hyperparathyroidism was eventually understood. It is obvious that no causal relationship between acromegaly and amyotrophic lateral sclerosis or muscular dystrophy has been discovered. Nevertheless, we believe that the coexistence of the apparently related changes in the 3 patients reported here as well as similar instances from the literature may represent more than mere coincidence. It may be that the peculiar metabolic imbalance which existed has had a more direct bearing upon the results than can be readily attributed to the disease as we know it. All 3 of our patients suffered from frank acromegaly, and the diagnosis of amyotrophic lateral sclerosis was made in each one by the consultant in neurology. One of the patients died, and the diagnosis of amyotrophic lateral sclerosis was proved at autopsy. We recognized that the subsequent improvement manifested by the remaining 2 patients rendered the diagnosis of amyotrophic lateral sclerosis, as usually accepted, less certain in them, and for that reason these cases might be better classified as the amyotrophic type of acromegaly.
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