ArticleFrontiers in endocrinology2026
Micromegaly: a distinct clinical entity? Insights from a monocentric cohort study.
Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The term "micromegaly" historically refers to patients with acromegalic features, elevated IGF-1, but normal growth hormone (GH) levels. The physiological mechanism, the appropriate clinical and treatment approaches, as well as its existence as a separate clinical entity are not well-defined. Methods: We retrospectively collected clinical and hormonal data from 30 patients with acromegaly and 30 with micromegaly (displaying high IGF-1 but GH < 0.4 µg/L after glucose load), matched for age and sex. Data about acromegaly related comorbidities were collected (goiter, colonic polyps, malignancies, hypertension, cardiopathy, obstructive-sleep-apnea, carpal tunnel, and hyperglycemia). We performed a laboratory analysis of pituitary tissue samples from both groups, examining GH isoform expression and proliferative rate. We compared data of the two groups and described follow-up and treatment response in micromegalic patients. Results: Patients with acromegaly exhibited higher IGF-1 values at diagnosis (+8.3 vs. +3.2 SDS, Conclusion: Patients with a clinical diagnosis of acromegaly and high IGF-1 levels but a GH nadir < 0.4 µg/L following glucose load exhibit a high burden of comorbidities and therefore require appropriate screening and follow-up. Therapeutic strategies in these cases should be individualized, considering the frequent absence of neuroradiological findings, which may reflect a lower proliferative profile.
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