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2015, Number 1

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Rev Med Inst Mex Seguro Soc 2015; 53 (1)

Current diagnosis and treatment of acromegaly

Melgar V, Espinosa E, Cuenca D, Valle V, Mercado M

Language: Spanish
References: 28
Page: 74-83
PDF size: 147.68 Kb.


ABSTRACT

Acromegaly is a rare condition characterized by the excessive secretion of growth hormone (GH), usually by a pituitary adenoma. The clinical manifestations of acromegaly include enlarged hands, feet and face, headaches, arthralgias, fatigue and hyperhydrosis. This condition is also associated with comorbidities such as hypertension and diabetes in a signifi cant proportion of patients and frequently compromises life quality and life expectancy. The biochemical diagnosis of acromegaly rests on the demonstration of an autonomous secretion of GH by means of the measurement of glucose-suppressed GH levels and the serum concentration of insulin like growth factor type 1 (IGF-1). The localizing method of choice is magnetic resonance image of the selar area, which in 70 % of the cases reveals the presence of a macroadenoma. Even though the primary treatment is usually the transsphenoidal resection of the adenoma, the majority of patients require a multimodal intervention that includes radiotherapy, as well as pharmacological therapy with somatostatin analogs and dopamine agonists. The latter approach has resulted in a signifi cant reduction in mortality and in an improvement in the quality of life.


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