Challenges Confounding Biochemical Diagnosis of Acromegaly.

Biochemical Diagnosis of Acromegaly.

Abstract

Abstract:

Acromegaly is a disorder caused by growth hormone (GH) hypersecretion resulting in excessive release of insulin like growth factor-1 (IGF-1). Both GH and IGF-1 measurements are crucial in its accurate diagnosis and in differentiating it from pseudoacromegaly. Early diagnosis is frequently restricted by its subtle, unnoticeable pathological changes; hence, clinical presentation is often late. Therefore, biochemical diagnosis is critical. However, the straightforward interpretation of these markers are hindered by factors that contribute to GH – IGF-1 discordance observed both in static and in dynamic function tests. These factors include both markers biological variation and their analytical assay limitations, which lead to false positive and negative results. This review is describing the pitfalls and challenges confounding the biochemical diagnosis of acromegaly. Despite these interpretive challenges, we strongly believe that interpretation of these results could be facilitated by effective clinician-laboratory professional communications which is the highlight of this review.

Keywords: Acromegaly, growth hormone (GH), insulin like growth factor-1 (IGF-1), IGF-binding proteins (IGFBP)