{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:10:10Z","timestamp":1756278610474,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2021,8,1]],"date-time":"2021-08-01T00:00:00Z","timestamp":1627776000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,8,8]]},"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:p>Acromegaly is a rare disorder of unregulated hypersecretion of growth hormone that causes cardiovascular, metabolic and respiratory complications. Herein, we describe the case of a middle-aged man admitted to the hospital with severe COVID-19 found to have clinical and biochemical evidence of acromegaly. His respiratory status declined despite initiation of standard treatments, prompting initiation of subcutaneous octreotide. Following initiation of this therapy, he rapidly improved and was discharged from the hospital 2\u2009days later. Subsequent workup revealed a pituitary macroadenoma that was surgically removed, with improvement in his acromegaly symptoms. COVID-19 disease severity is increased by pre-existing diabetes, lung disease and immunosuppression. Although this patient had obstructive sleep apnoea and pre-diabetes, we hypothesise that our patient\u2019s acromegaly contributed to his severe course, as reflected by his rapid improvement after starting treatment with subcutaneous octreotide. Acromegaly may predispose to more severe outcomes in patients with COVID-19.<\/jats:p>","DOI":"10.1136\/bcr-2021-243900","type":"journal-article","created":{"date-parts":[[2021,8,17]],"date-time":"2021-08-17T13:05:36Z","timestamp":1629205536000},"page":"e243900","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Severe respiratory failure in a patient with COVID-19 and acromegaly: rapid improvement after adding octreotide"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6040-3448","authenticated-orcid":false,"given":"Jacob","family":"Luty","sequence":"first","affiliation":[{"name":"Medicine, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LesleAnn","family":"Hayward","sequence":"additional","affiliation":[{"name":"Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie","family":"Jackson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P Barton","family":"Duell","sequence":"additional","affiliation":[{"name":"Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,8,17]]},"reference":[{"key":"2025082623290258000_14.8.e243900.1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmcp2009575"},{"key":"2025082623290258000_14.8.e243900.2","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1055\/a-1172-1352","article-title":"Endocrine conditions and COVID-19","volume":"52","author":"Shekhar","year":"2020","journal-title":"Horm Metab Res"},{"key":"2025082623290258000_14.8.e243900.3","first-page":"1775","article-title":"Case-Fatality rate and characteristics of patients dying in relation to COVID-19 in Italy","volume":"323","author":"Onder","year":"2020","journal-title":"JAMA"},{"key":"2025082623290258000_14.8.e243900.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30183-5"},{"key":"2025082623290258000_14.8.e243900.5","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2006.01861.x"},{"key":"2025082623290258000_14.8.e243900.6","doi-asserted-by":"crossref","first-page":"345","DOI":"10.2147\/DMSO.S100074","article-title":"Novel biomarkers for prediabetes, diabetes, and associated complications","volume":"10","author":"Dorcely","year":"2017","journal-title":"Diabetes Metab Syndr Obes"},{"key":"2025082623290258000_14.8.e243900.7","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-020-01035-2"},{"key":"2025082623290258000_14.8.e243900.8","doi-asserted-by":"publisher","DOI":"10.1007\/s11102-016-0772-8"},{"key":"2025082623290258000_14.8.e243900.9","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.58.681.429"},{"key":"2025082623290258000_14.8.e243900.10","unstructured":"Bhimraj A , Morgan RL , Shumaker AH . Infectious diseases Society of America guidelines on the treatment and management of patients with COVID-19. infectious diseases Society of America 2021; version 4.4.1. Available: https:\/\/www.idsociety.org\/practice-guideline\/covid-19-guideline-treatment-and-management\/ [Accessed 28 Jun 2021]."},{"key":"2025082623290258000_14.8.e243900.11","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2018.00722","article-title":"3D facial analysis in acromegaly: gender-specific features and clinical correlations","volume":"9","author":"Guo","year":"2018","journal-title":"Front Endocrinol"},{"key":"2025082623290258000_14.8.e243900.12","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1007\/s13555-016-0160-3","article-title":"Skin manifestations of insulin resistance: from a biochemical stance to a clinical diagnosis and management","volume":"7","author":"Gonz\u00e1lez-Saldivar","year":"2017","journal-title":"Dermatol Ther"},{"key":"2025082623290258000_14.8.e243900.13","doi-asserted-by":"publisher","DOI":"10.1210\/er.2002-0022"},{"key":"2025082623290258000_14.8.e243900.14","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2014-2700"},{"key":"2025082623290258000_14.8.e243900.15","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1007\/s11102-020-01059-7","article-title":"Pituitary Society guidance: pituitary disease management and patient care recommendations during the COVID-19 pandemic-an international perspective","volume":"23","author":"Fleseriu","year":"2020","journal-title":"Pituitary"},{"key":"2025082623290258000_14.8.e243900.16","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3803\/EnM.2019.34.1.53","article-title":"Medical treatment with somatostatin analogues in acromegaly: position statement","volume":"34","author":"Chin","year":"2019","journal-title":"Endocrinol Metab"},{"key":"2025082623290258000_14.8.e243900.17","doi-asserted-by":"crossref","unstructured":"Mercuri V , D\u2019Amico T , Gargiulo P . Letter to the Editor: \u201cCOVID\u201019 and the endocrine system: exploring the unexplored\u201d Focus on acromegaly. Journal of Endocrinological Investigation 2020:1\u20132.","DOI":"10.1007\/s40618-020-01418-y"},{"key":"2025082623290258000_14.8.e243900.18","doi-asserted-by":"crossref","first-page":"553","DOI":"10.4236\/ijcm.2019.1010045","article-title":"Respiratory disorders in acromegalic patients","volume":"10","author":"Mercuri","year":"2019","journal-title":"Int J Clin Med"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-243900","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T06:29:15Z","timestamp":1756276155000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-243900"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,8]]},"references-count":18,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,8,17]]},"published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1136\/bcr-2021-243900"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-243900","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2021,8]]}}}