Rosário Pedro W, Purisch Saulo
Laboratório ANALYS, Belo Horizonte, MG, Brazil.
Arq Bras Endocrinol Metabol. 2010 Aug;54(6):546-9. doi: 10.1590/s0004-27302010000600006.
To evaluate the frequency of subclinical acromegaly (in the absence of clinical phenotype but biochemically uncontrolled) in patients with prolactinoma during treatment with dopaminergic agonists.
One hundred twenty one patients without a phenotype suggestive of acromegaly were studied.
Initially, the laboratory diagnosis of acromegaly was unequivocal (elevated IGF-1 for gender and age with nadir GH > 1 μg/L) in two patients, and likely (elevated IGF-1 with nadir GH > cut-off but < 1 μg/L) in another patient. In two other patients, this diagnosis was possible (normal IGF-1 with nadir GH > 1 μg/L). Repetition of the tests 6 months after withdrawal of the dopaminergic agonist confirmed the diagnosis of subclinical acromegaly (elevated IGF-1 for gender and age with nadir GH > 1 μg/L) in these 5 patients. False-positive results were excluded in all cases.
In patients with prolactinomas, acromegaly should be investigated not only in cases with a clinical phenotype.
评估多巴胺能激动剂治疗期间泌乳素瘤患者中亚临床肢端肥大症（无临床表型但生化指标未得到控制）的发生频率。
对121例无肢端肥大症提示性表型的患者进行了研究。
最初，两名患者的肢端肥大症实验室诊断明确（根据性别和年龄，IGF-1升高且最低生长激素>1μg/L），另一名患者可能患有肢端肥大症（IGF-1升高且最低生长激素>临界值但<1μg/L）。在另外两名患者中，也有可能诊断为此病（IGF-1正常但最低生长激素>1μg/L）。停用多巴胺能激动剂6个月后重复检测，证实这5例患者患有亚临床肢端肥大症（根据性别和年龄，IGF-1升高且最低生长激素>1μg/L）。所有病例均排除假阳性结果。
对于泌乳素瘤患者，不仅应对有临床表型的病例进行肢端肥大症调查。
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