Ran X, Zhang L, Xiong P, Zhao T, Tong N, Li X
Endocrinology/Internal Medicine, First Affiliated Hospital, WCUMS, Chengdu 610041, China.
Hua Xi Yi Ke Da Xue Xue Bao. 2001 Dec;32(4):621-3.
Gigantism with low or normal basal concentrations of growth hormone (GH) is a rare condition, possibly due to abnormal GH secretory patterns, enhanced tissue sensitivity to GH, or the existence of an unidentified growth promoting factor. Here we report an 11 year-old female case of gigantism with a normal pituitary gland. Her height was 181 cm, body weight 77 kg, and bone age 11.1 years. Her basal serum GH levels were lower than 1 ng/ml. The levels of T3, T4, FT3, FT4, TSH, E2, LH, FSH, PRL, PTC and ACTH were normal. Serum GH response to insulin-induced hypoglycemia or arginine stimulation tests was blunted. In this case, non-pulsatile GH secretion and enhanced tissue sensitivity to GH may induce hypersecretion of IGF-1 and the existence of an unidentified growth promoting factor or biologically active anti-GH receptor antibodies may cause clinical gigantism.
生长激素(GH)基础浓度低或正常的巨人症是一种罕见病症,可能是由于GH分泌模式异常、组织对GH的敏感性增强,或存在尚未明确的生长促进因子。在此,我们报告一例11岁患巨人症的女性病例,其垂体正常。她身高181厘米,体重77千克,骨龄11.1岁。其基础血清GH水平低于1纳克/毫升。T3、T4、FT3、FT4、TSH、E2、LH、FSH、PRL、PTC和ACTH水平均正常。血清GH对胰岛素诱导的低血糖或精氨酸刺激试验的反应减弱。在该病例中,非脉冲式GH分泌以及组织对GH的敏感性增强可能诱导IGF-1分泌过多,而存在尚未明确的生长促进因子或具有生物活性的抗GH受体抗体可能导致临床巨人症。