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Acromegaly — SCE Endocrinology MCQ

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ModeratePituitaryAcromegalySCE Endocrinology

A 49-year-old man has enlarging hands, sweating and headaches. IGF-1 is elevated for age, and after a 75 g oral glucose tolerance test GH remains 8 micrograms/L at 2 hours. MRI shows a 9 mm pituitary adenoma not touching the chiasm. What is the most likely diagnosis?

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Correct answer: A — Acromegaly from a pituitary somatotroph adenoma

Raised IGF-1 with failure of GH suppression during OGTT confirms acromegaly, and a pituitary microadenoma is the common cause. Pseudoacromegaly has clinical features without biochemical GH excess. The pearl is that random GH is unreliable; suppression testing is key.

Reference: Endocrine Society acromegaly guideline, Society for Endocrinology guidance