Acromegaly with initial negative oral glucose tolerance test: a case report

Autor: Wen-Hsuan Tsai, Ming-Nan Chien, Shuen-Han Dai, Yun-Kai Chan
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Journal of Medical Case Reports, Vol 17, Iss 1, Pp 1-6 (2023)
Druh dokumentu: article
ISSN: 1752-1947
DOI: 10.1186/s13256-023-04064-z
Popis: Abstract Background Acromegaly can be diagnosed by a growth hormone value ≥ 1 µg/L following an oral glucose tolerance test. However, normal growth hormone suppression following oral glucose tolerance test may not exclude acromegaly. Case presentation We present a case of a 55-year-old Chinese man with pituitary macroadenoma incidentally noted after a traffic accident. He reported feet enlargement in the past few years. At the beginning, elevated insulin-like growth factor-1 was noted with growth hormone value 1 µg/L. Endoscopic endonasal approach to the remove pituitary macroadenoma was performed subsequently. After the resection of the pituitary macroadenoma, pathology showed positive staining of growth hormone and prolactin. Insulin-like growth factor-1 normalized as well. Conclusions Suppressed growth hormone after oral glucose tolerance test cannot exclude acromegaly, and some patients may have only mild or no clinical presentation of acromegaly. Patients with pituitary microadenoma or macroadenoma and elevated insulin-like growth factor-1 should be closely monitored for signs/symptoms of acromegaly and hypopituitarism.
Databáze: Directory of Open Access Journals
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