Acromegaly with Normal Insulin-Like Growth Factor-1 Levels and Congestive Heart Failure as the First Clinical Manifestation.
10.3803/EnM.2015.30.3.395
- Author:
Hyae Min LEE
1
;
Sun Hee LEE
;
In Ho YANG
;
In Kyoung HWANG
;
You Cheol HWANG
;
Kyu Jeung AHN
;
Ho Yeon CHUNG
;
Hui Jeong HWANG
;
In Kyung JEONG
Author Information
1. Department of Endocrinology and Metabolism, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea. jik1016@dreamwiz.com
- Publication Type:Case Report
- Keywords:
Acromegaly;
Heart failure;
Insulin-like growth factor I
- MeSH:
Acromegaly*;
Arrhythmias, Cardiac;
Estrogens, Conjugated (USP)*;
Growth Hormone;
Heart Failure*;
Humans;
Hypertension;
Hypertrophy;
Insulin-Like Growth Factor I;
Mortality;
Pituitary Neoplasms
- From:Endocrinology and Metabolism
2015;30(3):395-401
- CountryRepublic of Korea
- Language:English
-
Abstract:
The leading cause of morbidity and mortality in patients with acromegaly is cardiovascular complications. Myocardial exposure to excessive growth hormone can cause ventricular hypertrophy, hypertension, arrhythmia, and diastolic dysfunction. However, congestive heart failure as a result of systolic dysfunction is observed only rarely in patients with acromegaly. Most cases of acromegaly exhibit high levels of serum insulin-like growth factor-1 (IGF-1). Acromegaly with normal IGF-1 levels is rare and difficult to diagnose. Here, we report a rare case of an acromegalic patient whose first clinical manifestation was severe congestive heart failure, despite normal IGF-1 levels. We diagnosed acromegaly using a glucose-loading growth hormone suppression test. Cardiac function and myocardial hypertrophy improved 6 months after transsphenoidal resection of a pituitary adenoma.
