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Endocrinology • Pituitary Disorders
How do you evaluate remission in acromegaly when postoperative IGF-1 and GH levels are discordant?
Answer from: at Community Practice
It depends how long after surgery. IGF-1 may take up to 3 months form curative surgery to normalize. If GH is low (<0.4 ng/mL) and IGF-1 is still abnormal and you are less than 3 months form surgery, I would just wait. If the opposite is true (Normal IGF-1 but elevated random GH), I would perform...
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Answer from: at Community Practice
IGF-I has longer half-life than GH so normal IGF-I suggests remission of acromegaly in most cases, except when IGF-I may be low due to other causes. If fasting GH is high, glucose suppression can help better define GH excess, if any. One should also assess based on symptoms of acromegaly and MRI res...