Current concepts in acromegaly: etiology, diagnosis, and treatment

Acromegaly is an insidious disorder of somatic growth and metabolic derangements that results from the chronic hypersecretion of growth hormone (GH) in the adult. While its precise incidence in this country remains undocumented, a recent epidemiologic study of a stable population of 3.1 million in England suggested an annual incidence of approximately 0.3 cases per 100,000, with a prevalence of diagnosed cases approaching 4 per 100,000. In the majority of cases the diagnosis, once considered, is not difficult, although in recent years the spectrum of possible etiologies has been considerably broadened. As with most diseases, the problems of diagnosis arise with the more subtle or less classical examples of the syndrome. This review will briefly discuss the possible etiologies and clinical presentation of acromegaly, and then focus on the diagnosis and management of this potentially devastating disease.