Acromegaly or chronic renal failure: a diagnostic dilemma.

Uraemic patients may have markedly elevated serum GH concentrations yet, for hitherto unknown reasons, they do not develop acromegaly. We discuss the diagnostic dilemma presented by a 33-year-old Caucasian male with chronic renal failure (creatinine clearance 10 ml/min) secondary to polycystic kidne...

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Bibliografische gegevens
Hoofdauteurs: Wong, N, Ahlquist, J, Camacho-Hübner, C, Goodwin, C, Dattani, M, Marshall, N, Wass, J
Formaat: Journal article
Taal:English
Gepubliceerd in: 1997
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author Wong, N
Ahlquist, J
Camacho-Hübner, C
Goodwin, C
Dattani, M
Marshall, N
Wass, J
author_facet Wong, N
Ahlquist, J
Camacho-Hübner, C
Goodwin, C
Dattani, M
Marshall, N
Wass, J
author_sort Wong, N
collection OXFORD
description Uraemic patients may have markedly elevated serum GH concentrations yet, for hitherto unknown reasons, they do not develop acromegaly. We discuss the diagnostic dilemma presented by a 33-year-old Caucasian male with chronic renal failure (creatinine clearance 10 ml/min) secondary to polycystic kidney disease, elevated GH concentrations (fasting concentration of 22.6 rising to 77.9 mU/l 30 minutes after a 75-g oral glucose load) as well as acromegalic features. Review of the patient's relatives and the findings of a normal serum IGF-I concentration and a normal pituitary fossa on magnetic resonance imaging, suggest that the patient's acromegalic appearance is a familial trait and his abnormal GH dynamics a result of his renal failure rather than acromegaly. The patient's normal GH bioactivity and reduced GH binding protein concentration supports the current belief that chronic renal failure leads to an increase in peripheral tissue resistance to GH due to decreased GH receptor numbers. These changes, together with reduced IGF-I bioactivity, may explain why patients with chronic renal failure do not develop acromegaly in the presence of abnormally elevated levels of GH.
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spelling oxford-uuid:f66ea1e6-1bdb-4318-ae40-c2c0300d027e2022-03-27T12:35:04ZAcromegaly or chronic renal failure: a diagnostic dilemma.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f66ea1e6-1bdb-4318-ae40-c2c0300d027eEnglishSymplectic Elements at Oxford1997Wong, NAhlquist, JCamacho-Hübner, CGoodwin, CDattani, MMarshall, NWass, JUraemic patients may have markedly elevated serum GH concentrations yet, for hitherto unknown reasons, they do not develop acromegaly. We discuss the diagnostic dilemma presented by a 33-year-old Caucasian male with chronic renal failure (creatinine clearance 10 ml/min) secondary to polycystic kidney disease, elevated GH concentrations (fasting concentration of 22.6 rising to 77.9 mU/l 30 minutes after a 75-g oral glucose load) as well as acromegalic features. Review of the patient's relatives and the findings of a normal serum IGF-I concentration and a normal pituitary fossa on magnetic resonance imaging, suggest that the patient's acromegalic appearance is a familial trait and his abnormal GH dynamics a result of his renal failure rather than acromegaly. The patient's normal GH bioactivity and reduced GH binding protein concentration supports the current belief that chronic renal failure leads to an increase in peripheral tissue resistance to GH due to decreased GH receptor numbers. These changes, together with reduced IGF-I bioactivity, may explain why patients with chronic renal failure do not develop acromegaly in the presence of abnormally elevated levels of GH.
spellingShingle Wong, N
Ahlquist, J
Camacho-Hübner, C
Goodwin, C
Dattani, M
Marshall, N
Wass, J
Acromegaly or chronic renal failure: a diagnostic dilemma.
title Acromegaly or chronic renal failure: a diagnostic dilemma.
title_full Acromegaly or chronic renal failure: a diagnostic dilemma.
title_fullStr Acromegaly or chronic renal failure: a diagnostic dilemma.
title_full_unstemmed Acromegaly or chronic renal failure: a diagnostic dilemma.
title_short Acromegaly or chronic renal failure: a diagnostic dilemma.
title_sort acromegaly or chronic renal failure a diagnostic dilemma
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