Acromegalic gigantism with low serum level of growth hormone and elevated serum insulin-like growth factor-I.
In a case of acromegalic gigantism with hyperprolactinemia is reported, the basal serum growth hormone (GH) levels ranged from 1.2 to 1.9 ng/ml. Serum GH response to either insulin-induced hypoglycemia or GH-releasing hormone was blunted. Frequent blood sampling showed non-pulsatile GH secretion. Serum prolactin and insulin-like growth factor-I (IGF-I) levels were elevated. After unsuccessful surgery, bromocriptine treatment normalized serum prolactin without affecting serum GH and IGF-I levels. Combined administration of octreotide with bromocriptine reduced serum GH and IGF-I levels. In this case, non-pulsatile GH secretion and enhanced tissue sensitivity to GH may induce hypersecretion of IGF-I and cause clinical acromegalic gigantism.
Miyazaki
R
R
First Department of Internal Medicine, Kyoto Prefectural University of Medicine.
Yoshida
T
T
Sakane
N
N
Yasuda
T
T
Umekawa
T
T
Kondo
M
M
Shimatsu
A
A
Hizuka
N
N
Sano
T
T
D000172:Acromegaly / Q000097:blood* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D000328:Adult; D001971:Bromocriptine / Q000494:pharmacology; D005877:Gigantism / Q000097:blood* / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D013006:Growth Hormone / Q000037:antagonists & inhibitors / Q000097:blood*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000037:antagonists & inhibitors / Q000378:metabolism*; D008297:Male; D015282:Octreotide / Q000494:pharmacology
D001971:Bromocriptine; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone; D015282:Octreotide