Pediatric Endocrinology Expert Forum
high IGF-1 in teenager
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Questions in the Pediatric Endocrinology forum are answered by Dr. Deanna L Aftab Guy. Topics covered include adrenal problems, diabetes insipidus, menstrual irregularities, obesity, parathyroid abnormalities, pituitary abnormalities, puberty concerns, rapid growth, rickets and bone disease, short stature, and thyroid.

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high IGF-1 in teenager

Hello,

My daughter went to the endocrinologist because we had some questions about hormones and growth. She is 15 years old and 11 months. Weights 130 pounds and is 5 ft. 9.in. She has had some ongoing menstrual irregularities, acne and some hair on her abdomen and stomach. She had a basal HGH value of 4.65 ng/ml and an IGF-1 of 726 ng/ml which was considered elevated according to the lab provided reference range of 15-25 year olds at 116-358 ng/ml. The endocrinologist wanted to do at MRI to rule out acromegaly. She was not entirely convinced of her decision,though, and was not sure how to interpret the IGF-1 level. My daughter has basically gone through a somewhat normal puberty and although she is tall she seems to have slowed down growing, only a couple of inches in  the past two years. If she had  excess growth hormone,wouldn't she have grown a lot more in the last two years? What does the high IGF-1 mean in a teenager and is it common? Should we have an OGTT done? Any advice  would be helpful. Thank you very much.
Sally
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I am not clear how she was worked up for abnormal periods and ended up with concerns for acromegaly. Her igf-1 level is actually normal range for age in our lab, random gh levels are hard to interpret. 5'9 may be perfectly normal for her parents heights. I would have repeat levels monitored and also the menstrual irregularity can be related to another completely different problem. Be sure she is with a pediatric endocrinologist. The oral glucose tolerance test (ogtt) is a way of checking the pituitary and if the gh reduces in response to the oral glucose challenge, if it remains high we worry that the gh is being produced in excess. It is hard to tell without seeing her, but my suspicion is that she needs further evaluation before we call it acromegaly.
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