Acromegaly is a rare hormonal disorder caused by the excessive secretion of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), typically due to a benign pituitary tumor called a somatotroph adenoma. This hormonal imbalance results in abnormal bone and tissue growth, leading to distinctive physical changes such as enlarged hands, feet, and facial features, as well as various metabolic complications that can impact overall health. In individuals with acromegaly, hypertriglyceridemia is the most common form of dyslipidemia, significantly raising the risk of acute pancreatitis, a potentially life-threatening condition marked by pancreatic inflammation and elevated blood enzyme levels.

This report presents a 47-year-old Iranian woman presenting with nausea, vomiting, and abdominal pain in the epigastric region, which was diagnosed with hypertriglyceridemia-induced acute pancreatitis according to the laboratory studies and imaging, and appropriate treatment was started. In the initial physical examination, the patient exhibited features of acromegaly, including a broad nose, enlarged jaw, enlarged hands and feet, and thickened skin. Additionally, the patient reported experiencing symptoms of hyperglycemia, including polydipsia and polyuria, for the past year, which had not been previously evaluated. Further investigation revealed the presence of diabetes mellitus. After recovering from acute pancreatitis, the patient underwent IGF-1 measurement due to clinical features of acromegaly and metabolic complications, which revealed elevated levels and confirmed the diagnosis. Meanwhile, the patient reported experiencing a severe headache and diplopia, prompting her to undergo a brain MRI that identified a large pituitary mass. Therefore, the patient was referred to the neurosurgery department for surgical intervention.

In conclusion, in patients with hypertriglyceridemia-induced acute pancreatitis, it is essential to assess for signs of acromegaly, as this may be the initial presentation of the condition.