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January 22, 1973

Medroxyprogesterone for Acromegaly

Author Affiliations

Walter Reed Army Medical Center Washington, DC

JAMA. 1973;223(4):442. doi:10.1001/jama.1973.03220040056026

To the Editor.—  In a case report of hyperosmolar nonketotic coma in an acromegalic patient (222:814, 1972), Paul Milloy dismisses the possibility that medroxyprogesterone acetate may have been a causative factor in the disorder. Our experience in a series of six acromegalic patients1 treated for up to six months with medroxyprogesterone showed a deterioration in glucose tolerance in five of the six patients. Glucose tolerance gradually improved after therapy with medroxyprogesterone was stopped. Jackson and Ormston2 had similar results in some of the acromegalics in their series, and Spellacy et al3 and Gershberg et al4 noted deterioration of glucose tolerance in nonacromegalics receiving medroxyprogesterone.Since Milloy's patient was the first acromegalic with hyperosmolar nonketotic coma ever described, and since her condition was subsequently controlled with diet alone, it may be reasonable to assume the medroxyprogesterone had a role in the development of the syndrome.Our data