{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:13:02Z","timestamp":1790374382201,"version":"4.1.0"},"reference-count":13,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,11,27]]},"abstract":"<jats:p>A young man with subtle clinical features suggestive of hypersomatotropism presented with acute-onset severe headache. Relevant investigations confirmed polycythaemia and growth hormone (GH)-secreting pituitary macroadenoma with apoplexy. Secondary polycythaemia and myeloproliferative disorders were ruled out. At follow-up after 3\u2009months, resolution of polycythaemia and acromegaly was observed, evident on normal haemoglobin levels, a normocellular marrow, and normal insulin-like growth factor-1 (IGF-1) with glucose-suppressed GH levels. Direct mitogenic properties of GH-IGF-1 axis on bone marrow progenitor cells may very rarely lead to erythroid hyperplasia and subsequent polycythaemia, reversible with successful therapy of acromegaly. In this case, polycythaemia secondary to hypersomatotropism likely resulted in pituitary apoplexy with subsequent remission of both acromegaly and resultant polycythaemia.<\/jats:p>","DOI":"10.1136\/bcr-2017-222669","type":"journal-article","created":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T05:20:31Z","timestamp":1512710431000},"page":"bcr-2017-222669","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Hypersomatotropism induced secondary polycythaemia leading to spontaneous pituitary apoplexy resulting in cure of acromegaly and remission of polycythaemia: \u2018The virtuous circle\u2019"],"prefix":"10.1136","volume":"2017","author":[{"given":"Shinjan","family":"Patra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sugata Narayan","family":"Biswas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joydip","family":"Datta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Partha Pratim","family":"Chakraborty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,12,7]]},"reference":[{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.1","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.blre.2016.06.001","article-title":"The 2016 revision of WHO classification of myeloproliferative neoplasms: clinical and molecular advances","volume":"30","author":"Barbui","year":"2016","journal-title":"Blood Rev"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.2","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/BF03343975","article-title":"Lymphocyte subset pattern in acromegaly","volume":"25","author":"Colao","year":"2002","journal-title":"J Endocrinol Invest"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.3","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s11102-011-0311-6","article-title":"Polycythemia as rare secondary direct manifestation of acromegaly: management and single-centre epidemiological data","volume":"15","author":"Zoppoli","year":"2012","journal-title":"Pituitary"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.4","doi-asserted-by":"crossref","first-page":"495","DOI":"10.7326\/0003-4819-124-5-199603010-00006","article-title":"Remission of polycythemia vera after surgical cure of acromegaly","volume":"124","author":"Grellier","year":"1996","journal-title":"Ann Intern Med"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.5","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-1048"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.6","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/BF03401328","article-title":"Gonadotropin secreting pituitary adenoma associated with erythrocytosis: case report and literature review","volume":"13","author":"Ceccato","year":"2014","journal-title":"Hormones"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.7","doi-asserted-by":"publisher","DOI":"10.1159\/000184757"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.mce.2008.02.022"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.9","first-page":"302","article-title":"Intracranial hemorrhage in patients with hematologic disorders","volume":"36","author":"Choi","year":"2004","journal-title":"J Korean Neurosurg Soc"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.beha.2005.07.011"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.11","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2700"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.12","doi-asserted-by":"publisher","DOI":"10.4158\/EP09126.CRR"},{"key":"2025042713125744000_2017.dec07_1.bcr-2017-222669.13","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-2670"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-222669","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T20:13:02Z","timestamp":1745784782000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-222669"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,12,7]]},"references-count":13,"alternative-id":["10.1136\/bcr-2017-222669"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-222669","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,12,7]]}}}