Acromegaly with normal growth hormone levels: response to Sandostatin-LAR treatment.
We report a case of acromegaly with relatively low GH secretion in a patient with GH-secreting pituitary macroadenoma. The 44-year-old male patient presented with left temporal hemianopsia and characteristic acromegalic face, but had relatively low baseline and post-glucose GH levels. IGF-1 and IGFBP-1 were elevated. Transsphenoidal surgery did not achieve clinical or biochemiacl remission, and the patient still had elevated IGF-1 levels with low GH. Histological examination of the resected tumor revealed a pituitary adenoma stained weakly for GH. The patient was treated then with monthly injections of Sandostatin-LAR, with clinical improvement and suppression of IGF-I to the normal range. This is a rare case of acromegaly without elevated GH levels, and good response to treatment with somatostatin analog, as expected in classical GH-secreting pituitary adenomas.
Shimon
I
I
Institute of Endocrinology, Chaim Sheba Medical Center, Tel-Hashomer, Israel. i_shimon@netvision.net.il
Nass
D
D
Hadani
M
M
D000172:Acromegaly / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D000236:Adenoma / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000097:blood / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D015282:Octreotide / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D010911:Pituitary Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D011388:Prolactin / Q000097:blood; D014785:Vision, Ocular / Q000187:drug effects / Q000502:physiology
D018931:Antineoplastic Agents, Hormonal; D018972:Insulin-Like Growth Factor Binding Protein 3; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I; D011388:Prolactin; D015282:Octreotide