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Acromegaly: pathogenesis, diagnosis, and management.

Maria Fleseriu1, Fabienne Langlois2, Dawn Shao Ting Lim3

  • 1Department of Medicine (Division of Endocrinology, Diabetes and Clinical Nutrition) and Department of Neurological Surgery, and Pituitary Center, Oregon Health & Science University, Portland, OR, USA.

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Acromegaly, caused by excess growth hormone (GH) and insulin-like growth factor 1 (IGF-1), requires tailored multimodal treatment. Addressing comorbidities and improving quality of life are key goals alongside tumor control.

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Area of Science:

  • Endocrinology
  • Oncology
  • Internal Medicine

Background:

  • Acromegaly stems from growth hormone-secreting pituitary adenomas, leading to excess GH and IGF-1.
  • These tumors, though typically benign, can be locally invasive and resistant to treatment.
  • Sustained high GH and IGF-1 levels cause significant cardiovascular, metabolic, and neoplastic comorbidities.

Purpose of the Study:

  • To review the epidemiology, pathogenesis, diagnosis, complications, and treatment of acromegaly.
  • To emphasize the importance of personalized management strategies for optimal patient outcomes.
  • To highlight the goals of normalizing IGF-1 and GH, tumor shrinkage, symptom relief, and improved quality of life.

Main Methods:

  • Comprehensive literature review on acromegaly.
  • Analysis of epidemiological data and disease pathogenesis.
  • Evaluation of current diagnostic and therapeutic approaches, including surgery, medical therapy, and radiation therapy.

Main Results:

  • Acromegaly management requires a multimodal approach.
  • Therapeutic aims include normalization of GH and IGF-1, tumor control, and management of associated comorbidities.
  • Individualized treatment plans are crucial for optimizing outcomes and improving quality of life.

Conclusions:

  • Effective management of acromegaly necessitates a personalized, multimodal strategy.
  • Addressing the diverse comorbidities associated with excess GH and IGF-1 is critical.
  • Tailoring treatment to individual patient needs is paramount for achieving optimal disease control and enhancing quality of life.