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Kaplan states
- IGf1 -- Best Test to confrim (Oral Gluc then Gh measurement may also cinfrim but not the best Test)
UW
-- IGF1 best Screening test but can also be elevated in other conditions. If + confrim w/ Oral Gluc then GH levels to confrim Dx)
What do u all think?? Any Other sources???
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can anyone check this in cmdt....
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Hi Ben,
THe following is from CMDT---
For screening purposes, a random serum IGF-I can be obtained. If it is normal for age, acromegaly is ruled out. For further evaluation, the patient should be fasting for at least 8 hours (except for water), not acutely ill, and should not have exercised on the day of testing. A serum specimen is obtained and assayed for the following: IGF-I (increased to over five times normal in most acromegalic patients), PRL (cosecreted by many GH-secreting tumors), glucose (diabetes is common in acromegaly), liver enzymes and blood urea nitrogen (BUN) (hepatic or renal failure can misleadingly elevate GH), serum calcium (to screen for hyperparathyroidism), serum inorganic phosphorus (frequently elevated), serum free T4, and TSH (secondary hypothyroidism is common in acromegaly; primary hypothyroidism may increase PRL; hyperthyroidism may occur as a result of excess TSH).
Glucose syrup (75 g) is then administered orally, and serum GH is measured 60 minutes afterward; acromegaly is excluded if the serum GH is less than 1 ng/mL (immunoradiometric assay [IRMA] or chemiluminescent assays). For ultrasensitive GH assays, GH should be suppressed to less than 0.3 ng/mL to exclude acromegaly.
