title: Acromegaly with normal growth-hormone levels and pituitary histology. Case report.
abstract: In rare cases, acromegalic patients have normal basal concentrations of growth hormone, and their acromegaly results from abnormal growth-hormone secretory patterns. A patient is reported with the clinical features of acromegaly, who had elevated somatomedin levels and an enlarged sella turcica, but whose serum growth-hormone levels on continuous monitoring were in the normal range, with levels of 2.8 to 8.9 ng/ml. Dynamic studies of growth hormone revealed normal responses to hypo- and hyperglycemia, but abnormal responses to L-dopa and thyroid-releasing hormone. At surgery, neither a pituitary adenoma nor eosinophilic hyperplasia was present. It is likely that this patient's acromegaly resulted from the presence of chronically high normal levels of growth hormone.
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000209:etiology* / Q000473:pathology; D000236:Adenoma / Q000175:diagnosis; D001706:Biopsy; D001786:Blood Glucose; D005947:Glucose; D013006:Growth Hormone / Q000097:blood*; D006801:Humans; D007980:Levodopa; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000175:diagnosis; D013002:Somatomedins / Q000097:blood; D013973:Thyrotropin-Releasing Hormone
chemical_list: D001786:Blood Glucose; D013002:Somatomedins; D007980:Levodopa; D013973:Thyrotropin-Releasing Hormone; D013006:Growth Hormone; D005947:Glucose