Abstract
We report a female child with a growth hormone (GH) secreting pituitary adenoma and hyperprolactinemia, diagnosed at 21 months, but with clinical signs in early infancy. Macrocephaly was noted at 3 months, and by 21 months head circumference was 55 cm (+5.5 SD). Linear growth was accelerated by age 6 months, and at 21 months height was 98 cm (+4.4 SD). CT scans at 21 months showed a pituitary tumor with suprasellar extension. Following complete surgical removal, immunohistochemical staining of the tumor tissue was positive for GH but not prolactin (Prl). Pertinent hormonal data demonstrated the following basal serum levels:
Growth velocity has remained normal (6 cm/yr) despite persistently low levels of GH (max 4.3 ng/ml following insulin, L-Dopa and arginine) .TRH stimulation failed to elicit a rise in either GH or Prl. We suggest that increased Prl resulted from hypothalamic damage, and we speculate that it is responsible for normal growth and Somatomedin-C (Sm-C). There has been no recurrence to date (age 3½ yrs). To our knowledge, this is the youngest verified case of acromegaly reported.
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Blumberg, D., Sklar, C., Bell, J. et al. ACROMEGALY PRESENTING IN INFANCY. Pediatr Res 21 (Suppl 4), 244 (1987). https://doi.org/10.1203/00006450-198704010-00463
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DOI: https://doi.org/10.1203/00006450-198704010-00463