A CASE-REPORT OF AN ELDERLY PATIENT WITH ACROMEGALY

We encountered a 91-year-old patient with acromegalic features. The se rum levels of growth hormone (GH) and insulin-like growth factor-I (IG F-I) were increased to 23.3 ng/ml and to 268 ng/ml, respectively. Both thyrotropin-releasing hormone and luteinizing hormone-releasing hormo ne tests demonstrated a 2-3 fold increase in the serum GH level. Magne tic resonance imaging disclosed a pituitary mass in the enlarged sella . The patient was diagnosed as having acromegaly due to overproduction of GH from a pituitary tumor. She manifested cardiac hypertrophy with severe aortic stenosis and mild hypertension, but without diabetes me llitus. After the administration of octreotide subcutaneously at a dos e of 25 to 50 mu g daily for 20 days, the serum GH level increased tra nsiently but decreased rapidly to approximately half the initial level , and suppression of the GH level persisted thereafter for over 2.5 mo nths. This patient seems to be the oldest patient with acromegaly amon g those reported in Japan.