2015
DOI: 10.1590/2359-3997000000010
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Abstract: Objective: To determine the frequency of indication of the GH suppression test and pituitary magnetic resonance imaging (MRI) in patients with clinical suspicion of acromegaly with GH concentrations > 0.4 µg/L despite normal serum IGF-1. Subjects and methods: A total of 160 patients with clinical suspicion of acromegaly with normal IGF-1 were studied. Results: Basal GH > 0.4 µg/L was observed in 70/88 women (79.5%). Nadir GH > 0.4 µg/L was found in 21/70 women (30%) and these patients were submitted to MRI, wh… Show more

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Cited by 5 publications
(4 citation statements)
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“…Basal GH > 0.4 µg/L was observed in 103 patients and nadir GH > 0.4 µg/L was found in 21 (30%) subjects, that were submitted to MRI, which revealed microadenoma in only two patients. These two patients continued to have normal IGF-1 values in subsequent measurements and no clinical progression was reported after 4 years [35].…”
Section: Normal Igf-1 Elevated Ghmentioning
confidence: 76%
“…Basal GH > 0.4 µg/L was observed in 103 patients and nadir GH > 0.4 µg/L was found in 21 (30%) subjects, that were submitted to MRI, which revealed microadenoma in only two patients. These two patients continued to have normal IGF-1 values in subsequent measurements and no clinical progression was reported after 4 years [35].…”
Section: Normal Igf-1 Elevated Ghmentioning
confidence: 76%
“…Although increasing sensitivity, the reduction in the nadir GH cut off from 1 µg/L to 0.4 µg/L may decrease the specificity of the diagnostic criterion. Indeed, even after the exclusion of interfering conditions and using sensitive assays calibrated against the second IS 98/574 for hGH, normal individuals, notably young adult and adult women, may have nadir GH > 0.4 µg/L in the OGTT (6,(35)(36)(37)(38). In the present series, all but one patient were women ≤ 55 years.…”
Section: Discussionmentioning
confidence: 62%
“…Thus, patients with a suspicious clinical scenario should be investigated even in the absence of a typical phenotype (1)(2)(3)(4)(5). Second, while normal IGF-1 virtually excludes the diagnosis of acromegaly (6), elevated concentrations of IGF-1 outside puberty and pregnancy strongly support the hypothesis. Third, the diagnosis of acromegaly is confirmed when elevated IGF-1 is associated with lack of GH suppression during an oral glucose tolerance test (OGTT).…”
Section: Introductionmentioning
confidence: 78%
“…IGF1 levels increase markedly when the influences of both placental GH and estrogen have completely ceased after delivery [34,36]. Thus estrogen-induced GH resistance is likely to be a major factor keeping IGF1 levels stable in spite of increasing placental GH and unrestrained tumor GH secretion during pregnancy [36,37].…”
Section: Gh and Igf1 Levels During Pregnancy And Puerperium In Women mentioning
confidence: 99%