title: A case report of an elderly patient with acromegaly.
abstract: We encountered a 91-year-old patient with acromegalic features. The serum levels of growth hormone (GH) and insulin-like growth factor-I (IGF-I) were increased to 23.3 ng/ml and to 268 ng/ml, respectively. Both thyrotropin-releasing hormone and luteinizing hormone-releasing hormone tests demonstrated a 2-3 fold increase in the serum GH level. Magnetic resonance imaging disclosed a pituitary mass in the enlarged sella. The patient was diagnosed as having acromegaly due to overproduction of GH from a pituitary tumor. She manifested cardiac hypertrophy with severe aortic stenosis and mild hypertension, but without diabetes mellitus. After the administration of octreotide subcutaneously at a dose of 25 to 50 micrograms daily for 20 days, the serum GH level increased transiently but decreased rapidly to approximately half the initial level, and suppression of the GH level persisted thereafter for over 2.5 months. This patient seems to be the oldest patient with acromegaly among those reported in Japan.
authors.affiliation: First Department of Internal Medicine, School of Medicine, University of Tokushima, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Wada
authors.forename: H
authors.initials: H
authors.lastname: Azuma
authors.forename: H
authors.initials: H
authors.lastname: Bando
authors.forename: Y
authors.initials: Y
authors.lastname: Shintani
authors.forename: S
authors.initials: S
authors.lastname: Saito
authors.forename: M
authors.initials: M
authors.lastname: Tamaki
authors.forename: H
authors.initials: H
authors.lastname: Arii
mesh_terms: D000172:Acromegaly / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications; D005260:Female; D007987:Gonadotropin-Releasing Hormone; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008279:Magnetic Resonance Imaging; D015282:Octreotide / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis; D013973:Thyrotropin-Releasing Hormone
chemical_list: D019382:Human Growth Hormone; D007987:Gonadotropin-Releasing Hormone; D013973:Thyrotropin-Releasing Hormone; D007334:Insulin-Like Growth Factor I; D015282:Octreotide