Would you evaluate for an ectopic source in a patient with persistently elevated IGF-1 level but no clinical features of acromegaly or evidence of pituitary abnormalities?
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How would you approach evaluating persistently elevated IGF-1 levels in a patient with no clinical features of acromegaly or evidence of pituitary abnormalities?
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Endocrinology · Johns Hopkins Endocrinology and Pituitary Center
Answered on · Updated on
Is this an IGF-1 drawn in the same lab? This may be falsely elevated. If so, I would repeat in a different lab or confirm/rule out acromegaly diagnosis by glucose suppression test. If the diagnosis is confirmed, measurement of GHRH to rule out a GHRH-secreting NET would be the next step.
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