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July 11, 1994

Normal Insulin-like Growth Factor-I in an Elderly Woman With Acromegaly and Medical Illness

Author Affiliations

From the Endocrine-Hypertension Division and Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (Dr Jaffe), and the Charles A. Dana Research Institute and the Harvard-Thorndike Laboratory of the Beth Israel Hospital, Department of Medicine (Divisions of Gerontology, Endocrinology, and Bone and Mineral Metabolism), Beth Israel Hospital and Harvard Medical School (Dr Rosen), Boston, Mass.

Arch Intern Med. 1994;154(13):1533-1535. doi:10.1001/archinte.1994.00420130131016

Insulin-like growth factor-I (IGF-I) has been advocated as a simple and reliable test for confirming the diagnosis of acromegaly and following a patient's response to treatment. We describe an elderly woman admitted to the hospital with altered mental status, congestive heart failure, and arthritis who was noted to have clear features of acromegaly. An IGF-I level was in the normal range, while results of an oral glucose tolerance test were diagnostic of acromegaly. As her medical condition, mobility, and nutrition improved, her IGF-I level increased above the normal range and continued to rise when she was seen as an outpatient. Therefore, illness, physical activity, nutritional status, and advanced age must be considered when interpreting IGF-I levels in patients with known or suspected acromegaly.

(Arch Intern Med. 1994;154:1533-1535)