[Acromegaly: a disorder with distinguished features yet delayed diagnosis]

The authors review the historical and epidemiological aspects, as well as the distinguishing clinical features and complications of acromegaly to emphasize the importance of early diagnosis and treatment of patients with this disorder. Acromegaly is a rare disorder with a prevalence of 55-69 cases per million population and an incidence of 3-4 newly detected cases per million per year. Recent estimates indicate, that its slow progression and insidious course leads to a considerable time lag of 7-12 years between the first symptoms and the diagnosis of the disease, although younger patients with more severe disease may be detected earlier. In addition to the disfigurement and disability which develop progressively from the onset of the disease, acromegaly is associated with a number of complications resulting in a two- or three-fold increase of mortality and a decrease of life expectancy by about 10 years. The major causes of death include cardiovascular and cerebrovascular events, respiratory disease and malignancy. Because the duration of the disease before effective therapy may be one of the major predictors of increased mortality, practicing doctors need to be particularly vigilant to recognize undiagnosed cases in order to avoid the serious complications of the disease.