睡眠時無呼吸症候群にて判明した末端肥大症の1例

A Case of Acromegaly Diagnosed after Developing Obstructive Sleep Apnea Syndrome

　はじめに

　末端肥大症は成長ホルモン（GH）の分泌過剰が骨端線閉鎖以降に起こり，四肢，末端が肥大する疾患で，また舌や鼻咽喉頭粘膜の肥厚により二次的に睡眠時の無呼吸が合併することも多い^1〜7）。

　今回われわれは，睡眠時の無呼吸の症状により末端肥大症が明らかになり，下垂体腺腫摘出術が奏効した1例を経験したので，文献的検討を加え報告する。

A 54-year-old man has complained of severe snor-ing and sleep apnea since 6 years ago. He had hypertrophy of the uvula, macroglosssia, and theenlarged nose, zygomatic bone, fingers and the prominent supra-orbital margin. The polysomno-graph showed an obstructive type of sleep apnea. The blood examination of growth hormone (GH) was undertaken because acromegaly was suspected from his physical features. GH level was elevated to 10.5 ng/ml and MRI showed a pituitary adenoma.

Diagnosed acromegaly with obstructive sleep apnea syndrome was made. After removal of the tumor with trans-sphenoidal approach, both sleep apnea and snoring almost disappeared.