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[Acromegaly].

Philippe Chanson1

  • 1Service d'endocrinologie et des maladies de la reproduction, Assistance publique des hôpitaux de Paris, Hôpital de Bicêtre, Faculté de médecine Paris-Sud, Université Paris XI, F-94275 Le Kremlin-Bicêtre, France. philippe.chanson@bct.ap-hop-paris.fr

Presse Medicale (Paris, France : 1983)
|November 14, 2008
PubMed
Summary
This summary is machine-generated.

Acromegaly, a rare disease from excess growth hormone (GH), is diagnosed late due to its slow progression. Effective treatments now improve prognosis, offering normal life expectancy with controlled GH and IGF-I levels.

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Area of Science:

  • Endocrinology
  • Rare Diseases
  • Oncology

Background:

  • Acromegaly results from excess growth hormone (GH) secretion, typically from pituitary adenomas.
  • The disease has an insidious onset, leading to late diagnosis (average age 40) and significant morbidity.
  • Acromegaly causes rheumatologic, cardiovascular, respiratory, and metabolic complications impacting prognosis.

Purpose of the Study:

  • To outline the diagnostic criteria for acromegaly.
  • To describe current therapeutic strategies for managing GH and IGF-I hypersecretion.
  • To highlight the improved prognosis and life expectancy with effective treatment.

Main Methods:

  • Diagnosis relies on elevated serum GH and insulin-like growth factor-I (IGF-I) levels.
  • Oral glucose tolerance test (OGTT) is used to confirm diagnosis by assessing GH suppression.
  • Current diagnostic cutoffs for GH nadir during OGTT are being re-evaluated with sensitive assays.

Main Results:

  • Treatment aims to decompress the pituitary, normalize GH and IGF-I levels, and prevent complications.
  • A stepwise therapeutic approach includes surgery, somatostatin analogs, radiotherapy, and GH antagonists.
  • Successful disease control is achieved in most patients, normalizing life expectancy.

Conclusions:

  • Acromegaly diagnosis requires careful evaluation of GH and IGF-I levels, with evolving diagnostic criteria.
  • Multimodal treatment strategies effectively manage GH hypersecretion and its associated health risks.
  • Modern management significantly improves patient outcomes, leading to a normal life expectancy.