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Tổng quan
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.
Chẩn đoán
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.
Xử trí
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.
