-
Deutsche Medizinische Wochenschrift... Jul 2006
Review
Topics: Acromegaly; Adenoma; Aged; Carcinoma; Cardiovascular Diseases; Colorectal Neoplasms; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Quality of Life
PubMed: 16933196
DOI: 10.1055/s-2006-947819 -
Expert Review of Endocrinology &... 2024Medical treatment of acromegaly is based in a `trial and error` approach. First-generation somatostatin receptor ligands (fg-SRL) are prescribed as first-line medical... (Review)
Review
INTRODUCTION
Medical treatment of acromegaly is based in a `trial and error` approach. First-generation somatostatin receptor ligands (fg-SRL) are prescribed as first-line medical therapy to the vast majority of patients, despite lack of disease control in approximately 60% of patients. However, other drugs used in acromegaly treatment are available (cabergoline, pasireotide and pegvisomant).
AREAS COVERED
In this article, we review and discuss the biomarkers of response to medical treatment in acromegaly.
EXPERT OPINION
Biomarkers for fg-SRL that can already be applied in clinical practice are: gender, age, pretreatment GH and IGF-I levels, cytokeratin granulation pattern, and the expression of somatostatin receptor type 2. Using biomarkers of response could guide treatment towards precision medicine with greater efficacy and lower costs.
Topics: Humans; Acromegaly; Biomarkers
PubMed: 38078447
DOI: 10.1080/17446651.2023.2293107 -
Archives of Endocrinology and Metabolism 2019Acromegaly is a systemic disease associated with increased morbidity, presenting cardiovascular, metabolic, respiratory, neoplastic, endocrine, articular and bone... (Review)
Review
Acromegaly is a systemic disease associated with increased morbidity, presenting cardiovascular, metabolic, respiratory, neoplastic, endocrine, articular and bone complications. Most of these comorbidities can be prevented or delayed with adequate disease treatment and, more recent studies with the use of modern treatments of acromegaly, have shown a change in the severity and prevalence of these complications. In addition, acromegaly is associated with increased mortality, but recent studies (especially those published in the last decade) have shown a different scenario than older studies, with mortality no longer being increased in adequately controlled patients and a change in the main cause of death from cardiovascular disease to malignancy. In this review, we discuss this changing face of acromegaly summarizing current knowledge and evidence on morbimortality of the disease. Arch Endocrinol Metab. 2019;63(6):630-7.
Topics: Acromegaly; Cause of Death; Humans
PubMed: 31939488
DOI: 10.20945/2359-3997000000193 -
Frontiers of Hormone Research 2018Diabetes is recognized as one of the most common acromegaly co-morbidities with a prevalence ranging 20-53%, while over one-third of these patients have an altered lipid... (Review)
Review
Diabetes is recognized as one of the most common acromegaly co-morbidities with a prevalence ranging 20-53%, while over one-third of these patients have an altered lipid profile. In fact, as in the non-acromegalic population, carbohydrate and lipid metabolism abnormalities are closely linked. Long term exposure to an excess of growth hormone (GH) and Insulin-like growth factor-1 concentrations results in insulin resistance and an increased hepatic glucose production. The lipolytic effect of GH results in the mobilization of free fatty acids that further contributes to the decreased insulin sensitivity found in these patients. Some studies suggest that the presence of diabetes contributes to the increased mortality of acromegaly, although this remains controversial. Successful treatment of acromegaly usually results in significant, albeit incomplete improvements of the abnormal metabolic profile.
Topics: Acromegaly; Diabetes Mellitus; Humans
PubMed: 29895013
DOI: 10.1159/000486001 -
Endocrinology and Metabolism Clinics of... Sep 1987Acromegaly is caused by GH-secreting pituitary adenomas and, in rare cases, by ectopic production of GRH with resultant hypersecretion of GH. Important systemic... (Review)
Review
Acromegaly is caused by GH-secreting pituitary adenomas and, in rare cases, by ectopic production of GRH with resultant hypersecretion of GH. Important systemic manifestations include acral enlargement, swelling, disfigurement, glucose intolerance and diabetes, hypertension, nerve entrapment, arthropathy, and cardiac disease. Tumor-related major manifestations are visual impairment, oculomotor paralysis, and hypopituitarism. Morbidity is substantial, and mortality is increased. Diagnosis should be made as early as possible by measuring plasma GH after an oral glucose load and plasma somatomedin C levels. Assessment of a pituitary lesion is best made by CT scanning in the coronal plane. Therapy is mandatory and consists of surgical removal of the pituitary adenoma (usually by the transsphenoidal route) or of the ectopic source of GRH (carcinoids or islet cell tumors). Adjunctive radiation and/or drug therapy is often necessary if complete surgical ablation of the adenoma is not possible. Radiation therapy can be administered as conventional supervoltage x-ray treatment or in the form of heavy particle beams. Drugs effective in partially lowering GH levels are bromocriptine and (not yet released) somatostatin analogues. Long-term follow-up of treated patients is important to guard against recurrence, progression, or development of hypopituitarism.
Topics: Acromegaly; Diagnosis, Differential; Growth Hormone; Humans; Insulin-Like Growth Factor I; Prognosis
PubMed: 3319599
DOI: No ID Found -
Endocrinology and Metabolism Clinics of... Dec 1997Acromegaly can be a serious, chronic, debilitating condition. The disease is often missed for years, resulting in significantly delayed diagnosis. This article reviews... (Review)
Review
Acromegaly can be a serious, chronic, debilitating condition. The disease is often missed for years, resulting in significantly delayed diagnosis. This article reviews recent advances in our understanding of acromegaly and the impact of current approaches on the diagnosis and monitoring of patients with this disorder.
Topics: Acromegaly; Adenoma, Acidophil; Humans; Pituitary Neoplasms; Prevalence
PubMed: 9429856
DOI: 10.1016/s0889-8529(05)70278-4 -
Endocrinology and Metabolism Clinics of... Sep 2001Acromegaly is a slow developing disease caused by hypersecretion of growth hormone and insulin-like growth factor 1. Increased morbidity and mortality associated with... (Review)
Review
Acromegaly is a slow developing disease caused by hypersecretion of growth hormone and insulin-like growth factor 1. Increased morbidity and mortality associated with the disease make early diagnosis and treatment crucial. This article reviews the etiology, clinical manifestations, and diagnosis of acromegaly, with an emphasis on newly available therapeutic options.
Topics: Acromegaly; Humans
PubMed: 11571931
DOI: 10.1016/s0889-8529(05)70202-4 -
BMJ (Clinical Research Ed.) Oct 2007Acromegaly may be a rare condition and difficult to diagnose. This patient's story highlights the importance of inquisitive questioning in cases with no obvious... (Review)
Review
Acromegaly may be a rare condition and difficult to diagnose. This patient's story highlights the importance of inquisitive questioning in cases with no obvious diagnosis.
Topics: Acromegaly; Anecdotes as Topic; Growth Hormone; Humans; Male; Patient Satisfaction; Physician-Patient Relations
PubMed: 17947788
DOI: 10.1136/bmj.39253.602141.AD -
Methodist DeBakey Cardiovascular Journal 2017In patients with acromegaly, chronic excess of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) leads to the development of acromegalic cardiomyopathy. Its... (Review)
Review
In patients with acromegaly, chronic excess of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) leads to the development of acromegalic cardiomyopathy. Its main features are biventricular hypertrophy, diastolic dysfunction, and in later stages, systolic dysfunction and congestive heart failure. Surgical and/or pharmacological treatment of acromegaly and control of cardiovascular risk factors help reverse some of these pathophysiologic changes and decrease the high risk of cardiovascular complications.
Topics: Acromegaly; Cardiovascular Diseases; Cardiovascular System; Human Growth Hormone; Humans; Insulin-Like Growth Factor I; Prognosis; Risk Factors
PubMed: 28740584
DOI: 10.14797/mdcj-13-2-64 -
Ugeskrift For Laeger Dec 2018Acromegaly is a rare and disabling disease with a plethora of symptoms and signs attributed to sustained elevations and actions of growth hormone and insulin-like growth...
Acromegaly is a rare and disabling disease with a plethora of symptoms and signs attributed to sustained elevations and actions of growth hormone and insulin-like growth factor 1. Acromegaly is characterised by excessive somatic growth and multiple comorbidities in addition to occasional compression of the optic nerve and hypopituitarism due to the underlying adenoma. The course of the disease is insidious, and a diagnostic delay of 5-10 years is typical, and this pre-diagnostic period is also associated with increased morbidity. Effective treatment is available, once the diagnosis is established.
Topics: Acromegaly; Adenoma; Comorbidity; Delayed Diagnosis; Human Growth Hormone; Humans
PubMed: 30520722
DOI: No ID Found