Wada M, Azuma H, Bando H, Shintani Y, Saito S, Tamaki M, Arii H
First Department of Internal Medicine, School of Medicine, University of Tokushima, Japan.
Endocr J. 1996 Dec;43(6):715-8. doi: 10.1507/endocrj.43.715.
We encountered a 91-year-old patient with acromegalic features. The serum levels of growth hormone (GH) and insulin-like growth factor-I (IGF-I) were increased to 23.3 ng/ml and to 268 ng/ml, respectively. Both thyrotropin-releasing hormone and luteinizing hormone-releasing hormone tests demonstrated a 2-3 fold increase in the serum GH level. Magnetic resonance imaging disclosed a pituitary mass in the enlarged sella. The patient was diagnosed as having acromegaly due to overproduction of GH from a pituitary tumor. She manifested cardiac hypertrophy with severe aortic stenosis and mild hypertension, but without diabetes mellitus. After the administration of octreotide subcutaneously at a dose of 25 to 50 micrograms daily for 20 days, the serum GH level increased transiently but decreased rapidly to approximately half the initial level, and suppression of the GH level persisted thereafter for over 2.5 months. This patient seems to be the oldest patient with acromegaly among those reported in Japan.
我们遇到了一位具有肢端肥大症特征的91岁患者。生长激素（GH）和胰岛素样生长因子-I（IGF-I）的血清水平分别升高至23.3 ng/ml和268 ng/ml。促甲状腺激素释放激素和促黄体生成素释放激素试验均显示血清GH水平升高了2至3倍。磁共振成像显示扩大的蝶鞍内有垂体肿块。该患者被诊断为因垂体肿瘤过度分泌GH而患有肢端肥大症。她表现出心脏肥大，伴有严重的主动脉瓣狭窄和轻度高血压，但无糖尿病。每日皮下注射25至50微克奥曲肽，持续20天，血清GH水平短暂升高，但迅速下降至初始水平的约一半，此后GH水平的抑制持续超过2.5个月。该患者似乎是日本报道的患肢端肥大症的最年长患者。
