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Acromegaly.

Massimo Scacchi1, Francesco Cavagnini

  • 1University of Milan, Ospedale San Luca, Istituto Auxologico Italiano, Milan, Italy.

Pituitary
|November 2, 2006
PubMed
Summary
This summary is machine-generated.

Acromegaly, a rare disorder of excess growth hormone (GH), increases mortality risk. Diagnosis involves elevated GH and IGF-I, confirmed by glucose load testing. Treatment options include surgery, medication, and radiotherapy.

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Area of Science:

  • Endocrinology
  • Oncology
  • Cardiology

Background:

  • Acromegaly is a rare, progressive disorder caused by excess growth hormone (GH).
  • It significantly increases mortality from cardiovascular disease, respiratory issues, and malignancies.
  • Prevalence is estimated at 40 cases per million, with 3-4 new cases annually.

Purpose of the Study:

  • To outline the diagnostic criteria for acromegaly.
  • To detail the recommended screening for associated complications.
  • To review current therapeutic strategies for acromegaly.

Main Methods:

  • Biochemical diagnosis using GH and IGF-I levels, with oral glucose load testing for confirmation.
  • Imaging techniques like CT scan or MRI to detect pituitary adenomas.

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  • Screening for cardiovascular complications (echocardiography, ECG), sleep apnea (polysomnography), and colon cancer (colonoscopy).

    • Main Results:

    • Surgery offers high success rates for microadenomas but lower rates for macroadenomas.
    • Medical therapies include GH-lowering drugs (somatostatin analogs, dopamine agents) and GH receptor antagonists (pegvisomant).
    • Radiotherapy is reserved for refractory cases due to side effects, with varying success rates.

    Conclusions:

    • Effective management of acromegaly requires a multidisciplinary approach, including diagnosis, complication screening, and tailored treatment.
    • Treatment aims to normalize GH and IGF-I levels, reduce tumor mass, and manage comorbidities.
    • Long-term monitoring is crucial for assessing treatment efficacy and preventing disease progression.