{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:15Z","timestamp":1784557035905,"version":"3.55.0"},"reference-count":14,"publisher":"Bioscientifica","content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,5,16]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Pachydermoperiostosis is a very rare osteoarthrodermopathic disorder whose clinical and radiographic presentations may mimic those of acromegaly. In the evaluation of patients with acromegaloid appearances, pachydermoperiostosis should be considered as a differential diagnosis. In this article, we report a 17-year-old boy who presented with 2-year history of acral enlargement and facial appearance changes associated with joint pain and excessive sweating. He had been investigated extensively for acromegaly, and the final diagnosis was pachydermoperiostosis.<\/jats:p>\n                  <jats:sec>\n                    <jats:title>Learning points<\/jats:title>\n                    <jats:list list-type=\"bullet\">\n                      <jats:list-item>\n                        <jats:p>There is a broad range of differential diagnosis for acromegaloid features such as acromegaly, pseudoacromegaly with severe insulin resistance, Marfan\u2019s syndrome, McCune\u2013Albright and a rare condition called pachydermoperiostosis.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Once a patient is suspected to have acromegaly, the first step is biochemical testing to confirm the clinical diagnosis, followed by radiologic testing to determine the cause of the excess growth hormone (GH) secretion. The cause is a somatotroph adenoma of the pituitary in over 95 percent of cases.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>The first step is measurement of a serum insulin-like growth factor 1 (IGF1). A normal serum IGF1 concentration is strong evidence that the patient does not have acromegaly.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>If the serum IGF1 concentration is high (or equivocal), serum GH should be measured after oral glucose administration. Inadequate suppression of GH after a glucose load confirms the diagnosis of acromegaly.<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Once the presence of excess GH secretion is confirmed, the next step is pituitary magnetic resonance imaging (MRI).<\/jats:p>\n                      <\/jats:list-item>\n                      <jats:list-item>\n                        <jats:p>Atypical presentation warrants revision of the diagnosis. This patient presented with clubbing with no gigantism, which is expected in adolescent acromegalics as the growth spurt and epiphyseal plate closure have not taken place yet.<\/jats:p>\n                      <\/jats:list-item>\n                    <\/jats:list>\n                  <\/jats:sec>","DOI":"10.1530\/edm-17-0029","type":"journal-article","created":{"date-parts":[[2017,5,16]],"date-time":"2017-05-16T07:38:43Z","timestamp":1494920323000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":12,"title":["Pachydermoperiostosis: a rare mimicker of acromegaly"],"prefix":"10.1530","volume":"2017","author":[{"given":"Noor Rafhati Adyani","family":"Abdullah","sequence":"first","affiliation":[{"name":"1Endocrinology Unit, Department of Medicine, Putrajaya Hospital, Putrajaya Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wong Lok Chin","family":"Jason","sequence":"additional","affiliation":[{"name":"2Department of Medicine, National University of Malaysia Medical Centre, Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azraai Bahari","family":"Nasruddin","sequence":"additional","affiliation":[{"name":"1Endocrinology Unit, Department of Medicine, Putrajaya Hospital, Putrajaya Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"key20170517160315058_bib1","first-page":"132","article-title":"Pachydermoperiostosis Mimicking Acromegaly: a case report","volume":"27","author":"Kwon","year":"2012","journal-title":"Archives of Rheumatology"},{"key":"key20170517160315058_bib2","first-page":"109","article-title":"Pachydermoperiostosis Masquerading as Acromegaly","volume":"1","author":"Karimova","year":"2017","journal-title":"Journal of the Endocrine Society"},{"key":"key20170517160315058_bib3","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1007\/BF02117271","article-title":"Hyperostose des gesammten skelettes","volume":"43","author":"Friedrich","year":"1868","journal-title":"Virchows Archiv. 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