Martínez-Delgado IA, Gómez-Martínez G

Language: Spanish
References: 9
Page: 311-314
PDF size: 92.22 Kb.

ABSTRACT

Background: acromegaly is a rare disease, it is characterized by elevation of the levels of growth hormone and Insulin-like growth factor 1 (IGF-1). The definitive treatment of this disease is surgical.
Objective: to know the importance of this clinical disease and to exhort to the medical community for opportune delivery to specialist, to prove diagnosis and to treat with opportunity in order to avoid complications.
Methods: the clinical files of the patients received at Endocrinology Service from 1995 to 2005 were reviewed. The data of serum growth hormone levels after a 75 g oral glucose tolerance test, tumor size, criteria for cure, co-morbidities, affectation of hormonal axes and visual field defects of operated patients and not operated patients, were collected.
Results: 84 patients were studied, 35 men and 49 women, with an average of 42 years of aged agreement to the Classification of Hardy Vezina, was greater number of cases in degree 2 (macro adenoma with local expansion of the chair). 35 patients with microadenomas: and 25 with macroadenomas were operated. The most frequent co-morbidities were the alteration in the metabolism of carbohydrates and hypertension, and a frequent hormonal affectation was hypothyroidism; the rate of biochemical cure was 7 %. Discordant results with levels of growth hormone high and normal levels of IGF-1 were in 10 %.
Conclusions: the present study confirms that the acromegaly is diagnosed late and it had been associated with co-morbidities and bigger tumor size, that they have influence on the surgical treatment results, since the rate of success were low (7 %).

REFERENCES

1. Holdaway IM, Rajasoorya C. Epidemiology of acromegaly. Pituitary 1999;2:29-41.

2. Colao A, Ferone D, Marzulio P, Lambordi G. Systemic complications of acromegaly: epidemiology, pathogenesis and management. Endocr Rev 2004; 25:102-105.

3. Ben-Shlomo A, Melmed S. Acromegaly. Endocrinol Metab Clin North Am 2001;30:565-583.

4. American Association of Clinical Endocrinologists. Acromegaly guidelines. Endocr Pract 2004;10(3): 214-2252.

5. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome. American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-2752.

6. Sociedad Mexicana de Nutrición y Endocrinología. Guía para el diagnóstico, tratamiento y seguimiento de la acromegalia, Rev Endocrinol Nutr 2004;12:3.

7. Barkan A. Radiotherapy in acromegaly: the argument against. Clin Endocrinol 2003;58:132-135.

8. Wass J. Radiotherapy in acromegaly: a protagonist’s viewpoint. Clin Endocrinol 2003;58:128-131.

9. Donangelo I, Shlomo M. Treatment of acromegaly. Endocrine 2005;28:123-128.