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Tests and diagnosis
By Mayo Clinic staffAs a first step toward diagnosis, your doctor will take a complete medical history and conduct a physical exam. Then he or she may recommend the following steps:
- Measuring IGF-1. Because growth hormone stimulates your liver to produce IGF-1 — another growth hormone — IGF-1 blood levels are nearly always elevated when you have acromegaly.
- Measuring growth hormone before and after you drink glucose. Your doctor may also test your growth hormone levels to confirm that you have acromegaly. In this test, your blood levels of growth hormone are measured both before and at several points after you drink a preparation of sugar (glucose). Normally, taking in glucose causes growth hormone levels to fall. But if your body is producing too much growth hormone, levels stay high.
- Imaging. After acromegaly has been diagnosed by measuring your IGF-1 and growth hormone levels, your doctor will likely recommend magnetic resonance imaging (MRI) of your brain to pinpoint the size and location of your tumor. Brain imaging may sometimes be performed with computerized tomography (CT). If brain imaging fails to detect a pituitary tumor, your doctor may recommend additional blood work and further imaging studies of your chest or abdomen.
References
- Melmed S, et al. Disorders of the anterior pituitary and hypothalamus. In: Fauci AS, et al. Harrison's Online. 17th ed. USA: McGraw-Hill; 2008. http://www.accessmedicine.com/content.aspx?aid=2876725. Accessed June 6, 2010.
- Fitzgerald PM. Acromegaly and gigantism. In: McPhee SJ, et al. Current Medical Diagnosis and Treatment 2010. 49th ed. USA: McGraw-Hill; 2010. http://www.accessmedicine.com/content.aspx?aID=14372&searchStr=acromegaly. Accessed June 6, 2010.
- Melmed S. Diagnosis of acromegaly. http://uptodate.com/home/index.html. Accessed June 6, 2010.
- Melmed S. Treatment of acromegaly. http://uptodate.com/home/index.html. Accessed June 6, 2010.
- Chapman IM. Gigantism and acromegaly. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec12/ch151/ch151f.html#sec12-ch151-ch151f-128. Accessed June 6, 2010.
- Acromegaly. National Institute of Diabetes and Digestive and Kidney Diseases. http://endocrine.niddk.nih.gov/pubs/acro/acro.htm. Accessed June 8, 2010.
- Vik-Mo EO, et al. Gamma knife stereotactic radiosurgery for acromegaly. European Journal of Endocrinology. 2007;157:255.
- Cook DM, et al. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Acromegaly. Endocrine Practice. 2004;10:213.
- Nippoldt TB (expert opinion). Mayo Clinic. Rochester, Minn. July 7, 2010.
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