title: A case of excess growth hormone levels.
abstract: Patients with anorexia nervosa are known to have elevated basal growth hormone levels, which fail to suppress normally during glucose tolerance testing. We describe a case of probable anorexia nervosa initially diagnosed as acromegaly despite a low insulin-like growth factor-1 level and treated with transsphenoidal surgery based on a pituitary microadenoma on magnetic resonance imaging and a lack of suppression of growth hormone levels during glucose tolerance testing. This case highlights, firstly, that pituitary magnetic resonance imaging will suggest a pituitary adenoma in up to 10% of normal individuals. Secondly, that a diagnosis of acromegaly should be made on clinical features as well as growth hormone measurements.
authors.affiliation: Department of Endocrinology, Imperial College Faculty of Medicine, Charing Cross Hospital, London W6 6RF, UK.
authors.forename: M
authors.initials: M
authors.lastname: Shariff
authors.forename: W S
authors.initials: WS
authors.lastname: Dhillo
authors.forename: L J
authors.initials: LJ
authors.lastname: Seal
authors.forename: J F
authors.initials: JF
authors.lastname: Todd
authors.forename: K
authors.initials: K
authors.lastname: Meeran
mesh_terms: D000172:Acromegaly / Q000175:diagnosis*; D000236:Adenoma / Q000175:diagnosis; D000328:Adult; D000568:Amenorrhea / Q000209:etiology; D000856:Anorexia Nervosa / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005951:Glucose Tolerance Test; D019382:Human Growth Hormone / Q000097:blood*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008279:Magnetic Resonance Imaging; D010911:Pituitary Neoplasms / Q000175:diagnosis
chemical_list: D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I