Acromegaly Disease Summary

Overview

Acromegaly is a chronic, slowly developing disease with progressive disfigurement and disability as defined in the Introduction section.  

Acromegaly is a rare disease. The Epidemiology section discusses the mean age of diagnosis of acromegaly and the prevalence of acne regionally.  

More than 95% of patients with acromegaly have hypersecretion of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) secondary to a GH-secreting pituitary adenoma that arises from somatotroph cells. The Pathophysiology section further discusses this. 

History and Physical Examination

The Clinical Presentation section enumerates the signs and symptoms of excess growth hormone and the symptoms caused by suprasellar extension of the pituitary adenoma.

Diagnosis

The Laboratory Tests and Ancillaries section discusses the different tests to be done to confirm diagnosis of acromegaly. While the Imaging section discusses modalities that can be performed when biochemical criteria for diagnosis are met.

As mentioned in the Diagnosis or Diagnostic Criteria section, it is imperative to have early diagnosis even though the signs and symptoms are difficult to distinguish with other metabolic and endocrine changes.

The Differential Diagnosis section enumerates the other causes of acromegaly.

Management

Surgical intervention is the first-line treatment for almost all patients with acromegaly unless there are contraindications, or the patient refuses to undergo the procedure. The eligibility, goals and transsphenoidal surgery are all discussed in the Surgery section.  

As mentioned in the Pharmacological Therapy section it is recommended when surgery is not suitable or in patients with persistent disease after surgical resection of the adenoma. Discussion about somatostatin analogs (SSA) or somatostatin receptor ligands (SRL), dopamine agonists, and growth hormone receptor antagonists are in this section.  

Radiotherapy is considered as an adjunctive treatment in patients not fully responding to surgical or pharmacological therapy. Further details on this are in the Radiation Therapy section.  

The Monitoring section enumerates the tests and assessment to be done during the first postoperative year and beyond.