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Acromegaly induced by growth hormone replacement therapy
Beate Karges1, Roland Pfäffle, Bernhard O Boehm
1University Children's Hospital, University of Ulm, Prittwitzstrasse 43, DE-89075 Ulm, Germany. beate.karges@medizin.uni-ulm.de
Hormone Research
|January 7, 2004
Summary
Recombinant human growth hormone (GH) therapy can lead to acromegaly in patients with hypopituitarism. Long-term monitoring of insulin-like growth factor 1 (IGF-1) is crucial to prevent this risk.
Area of Science:
- Endocrinology
- Pharmacology
Background:
- Recombinant human growth hormone (GH) is a standard treatment for growth disorders and GH deficiency.
- Idiopathic hypopituitarism requires careful management to avoid complications.
Observation:
- A 61-year-old man with idiopathic hypopituitarism developed active acromegaly during GH therapy.
- Elevated insulin-like growth factor 1 (IGF-1) levels were observed over 7 years, indicating potential over-treatment.
- Endogenous GH production and pituitary adenoma were ruled out as causes.
Findings:
- GH dose reduction normalized IGF-1 levels and stabilized the patient's clinical condition.
- No GH receptor polymorphisms were found, suggesting the issue was related to GH dosage.
- This case highlights the risk of acromegaly from indiscriminate recombinant GH use.
Implications:
- Long-term patient monitoring programs are essential for safe GH therapy.
- Careful dose adjustment and regular IGF-1 monitoring can prevent iatrogenic acromegaly.
- This underscores the importance of vigilant clinical assessment during hormone replacement therapy.
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