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Acromegaly.

Philippe Chanson1, Sylvie Salenave2, Peter Kamenicky1

  • 1Department of Endocrinology and Disorders of Reproduction, Hôpital Bicêtre and Reference Center for Rare Endocrine Disorders of Growth, Le Kremlin-Bicêtre, Paris, France; Faculty of Medicine, Université Paris-Sud 11, Le Kremlin-Bicêtre, Paris, France; INSERM U693, Le Kremlin-Bicêtre, Paris, France.

Handbook of Clinical Neurology
|September 25, 2014
PubMed
Summary
This summary is machine-generated.

Acromegaly, caused by excess growth hormone (GH), leads to disfigurement and systemic issues. Effective treatments, including surgery and medication, normalize GH and IGF-1 levels, improving life expectancy.

Keywords:
Acromegalygrowth hormoneinsulin-like growth factor 1pegvisomantpituitarysomatostatin analogs

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Area of Science:

  • Endocrinology
  • Oncology
  • Internal Medicine

Background:

  • Acromegaly results from excessive growth hormone (GH) production, typically from a pituitary adenoma.
  • It causes progressive somatic disfigurement and significant systemic complications affecting prognosis.
  • Prevalence is estimated at 40-130 cases per million.

Purpose of the Study:

  • To summarize the pathophysiology, diagnosis, and management of acromegaly.
  • To highlight the impact of comorbidities on patient outcomes.
  • To emphasize the effectiveness of current therapeutic strategies.

Main Methods:

  • Diagnostic confirmation involves assessing serum GH and insulin-like growth factor 1 (IGF-1) levels.
  • Treatment strategies include surgical resection, medical therapy (dopamine agonists, somatostatin analogs, pegvisomant), and radiotherapy.
  • Monitoring focuses on normalizing GH and IGF-1 levels and managing comorbidities.

Main Results:

  • Multistep therapeutic approaches achieve adequate hormonal control in most patients.
  • Normal life expectancy is attainable with effective disease management.
  • Comorbidities often improve post-treatment, though sequelae can persist.

Conclusions:

  • Acromegaly management requires a comprehensive strategy addressing hormonal excess and associated complications.
  • Current treatments significantly improve patient prognosis and quality of life.
  • Long-term monitoring is essential for managing persistent sequelae.