Acromegaly: a challenging condition to diagnose

Abstract

Acromegaly is an uncommon, chronic disease, characterized by hypersecretion of a pituitary growth hormone by somatotroph adenomas, along with increased levels of insulin-like growth factor-1. Although acromegaly presents a wide array of clinical manifestations, the salient symptoms include acral and soft tissue enlargement, joint pain, heart and respiratory failure, diabetes mellitus, and hypertension, leading to increased morbidity and mortality. Hence, early diagnosis of the disease is critical to enhance life expectancy and quality of life. New approaches are being developed for diagnosis and surveillance (both screening and follow-up), including sensitive biochemical assays and the use of MRI to visualize extremely small tumors, and are helpful in the early diagnosis of acromegaly, subsequent treatment, and disease control. This mini-review summarizes the most common and effective tools used in the diagnosis of acromegaly.

Combined therapy of somatostatin analogues with pegvisomant for the treatment of acromegaly: a meta-analysis of prospective studies

“…If data were not reported, we contacted the corresponding authors to obtain necessary data. The following data were extracted: (1) Quality assessment was performed by the investigators using the Cochrane risk-of-bias algorithm for controlled trials [18]and modified Methodological Index for Non-randomized Studies [19] for noncomparative studies.…”

“…Acromegaly is a rare, chronic and severe disease in which growth hormone (GH) is overproduced mainly due to GH-secreting pituitary. GH circulates and stimulates production of insulin-like growth factor 1 (IGF-1) from the liver and systemic tissues [1]. Therefore, serum levels of IGF-1 are usually used for assessment of disease control.…”

Pregnancy management in patients with acromegaly

“…In several researchers clinical activity of acromegaly has been variably shown to improve, remain stable, or worsen during pregnancy, but no clear correlation with hormone levels has been established [7,23]. In conclusion, hormonal assessment of acromegaly during pregnancy is challenging.…”

“…When a biochemical diagnosis has been established for acromegaly without any pituitary tumor or diffused pituitary enlargement is detected, ectopic sources should be suspected. Measurement of the plasma growth hormone-releasing hormone level is beneficial in identifying ectopic sources of tumor [7].…”

“…The meaning reflects one of the familiar symptoms of the disease, which is abnormal growth of hands and feet [6]. Nowadays acromegaly is diagnosed with increasing frequency and its mean age of onset coincides to a great extent with the child-bearing life of women [7].…”