Diagnosis and differential diagnosis of acromegaly - Med Notes
increase in Turkish saddle sizes and destruction of its walls, which allows not only to establish the presence of a tumor and its size, but also to identify the data on tumor growth direction.Lack sella change does not exclude the presence of a small pituitary adenomas and acromegaly.The increase in Turkish saddle at Statistics Team of acromegaly is diagnosed in 80-93% of patients, including 145 patients - at 137, but only 68% according to other patients.. great diagnostic value also have other radiological signs of acromegaly, in particular changes in the spine.. Just as in the diagnosis of hormonally inactive pituitary tumors, the diagnosis of acromegaly is very important ophthalmologic research, especially the dynamic monitoring of changes in visual fields.Has revealed bitemporal hemianopsia half of patients with ...http://mednotess.com/en/pages/1424139
Successful treatment of resistant acromegaly with a growth hormone receptor antagonist. - The Christie Research Publications...
BACKGROUND/OBJECTIVE: Pegvisomant is a pegylated analogue of human GH and functions as a potent GH receptor antagonist. This novel mode of action gives it the potential to achieve biochemical control in patients with acromegaly whose disease activity cannot be satisfactorily controlled by conventional therapy. We have documented the clinical details of seven patients with residual active acromegaly after surgery and/or radiation therapy successfully treated with pegvisomant. PATIENTS/METHODS: Seven patients (four male, mean age 47 years, range 34-67 years) who participated in two separate clinical trials of pegvisomant have completed 2 years (four patients) or 1 year (three patients) of treatment. All had active acromegaly (mean serum GH level ,5 mU/l; serum IGF-I elevated for age) that could not be controlled with standard medical therapy (dopamine agonist and/or a somatostatin analogue) following ...http://christie.openrepository.com/christie/handle/10541/82036
GH-secreting pituitary macroadenoma (acromegaly) associated with progressive dental malocclusion and refractory CPAP treatment ...
Pituitary adenomas are benign neoplasms arising from cells of the anterior pituitary gland and constitute 10-15% of intracranial tumors. From the clinicopathological point of view, they are divided into as somatotroph adenomas, which produce growth hormone; lactotroph adenomas, which produce prolactin; thyrotroph adenomas, which produce thyroid-stimulating hormone (TSH); corticotroph adenomas, which produce adrenocorticotropic hormone ACTH); and gonadotroph adenomas, which produce gonadotropin . It is extremely unusual for the dentist to suspect a somatotroph pituitary adenoma during a periodontal maintenance visit.. Patients with acromegaly are usually diagnosed late (,3 years) and at very advanced stages of the disease. In our case, the time to diagnosis was approximately two years; when OSAS was diagnosed, ...https://head-face-med.biomedcentral.com/articles/10.1186/s13005-017-0140-6
Growth Hormone-Secreting Pituitary Adenoma Summary Report | CureHunter
Growth Hormone-Secreting Pituitary Adenoma: A pituitary tumor that secretes GROWTH HORMONE. In humans, excess HUMAN GROWTH HORMONE leads to ACROMEGALY.http://www.curehunter.com/public/keywordSummaryD049912-Growth-Hormone-Secreting-Pituitary-Adenoma.do
Acromegaly | Health Information | MedCentral Health System
Acromegaly What is acromegaly? Acromegaly is the Greek word for 'extremities' and 'enlargement.' When the pituitary gland produces excess growth hormones, this results in excessive growth - called acromegaly. The excessive growth occurs first in the hands and feet, as soft tissue begins to swell. This rare disease affects mostly middle-aged adults. Untreated, the disease can lead to severe illness and death. What causes acromegaly? Overproduction of growth hormone (GH) by the pituitary gland over a long...http://www.medcentral.org/Main/StayWellProducts.aspx?iid=85_P00396&email=1
"Overgrowth: Missing a Tumor" Acromegaly without Imaging Evidence of Pituitary Adenoma and No Ectopic Source: A Case Report |...
Lonser R, Kindzelski BA, Mehta GU, Jane JA Jr., Oldfield EH. Acromegaly without imaging evidence of pituitary adenoma. J Clin Endocrinol Metab. 2010;95(9):4192-6. PMCID: PMC2936064. https://doi.org/10.1210/jc.2010-0570.. Khandelwal D, Khadgawat R, Mukund A, Suri A. Acromegaly with no pituitary adenoma and no evidence of ectopic source. Indian J Endocrinol Metab. 2011;15(Suppl 3):S250-2. PMCID: PMC3183531. https://doi.org/10.4103/2230-8210.84878.. Katznelson L, Laws E, Melmed S, et al. Acromegaly: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(11):3933-51. PMID: 25356808. https://doi.org/10.1210/jc.2014-2700.. Mercado M, Borges F, Bouterfa H, et al. A prospective, multicenter study to investigate the efficacy, safety and tolerability of octreotide LAR (long-acting ...http://asean-endocrinejournal.org/index.php/JAFES/article/view/419
"Overgrowth: Missing a Tumor" Acromegaly without Imaging Evidence of Pituitary Adenoma and No Ectopic Source: A Case Report |...
Lonser R, Kindzelski BA, Mehta GU, Jane JA Jr., Oldfield EH. Acromegaly without imaging evidence of pituitary adenoma. J Clin Endocrinol Metab. 2010;95(9):4192-6. PMCID: PMC2936064. https://doi.org/10.1210/jc.2010-0570.. Khandelwal D, Khadgawat R, Mukund A, Suri A. Acromegaly with no pituitary adenoma and no evidence of ectopic source. Indian J Endocrinol Metab. 2011;15(Suppl 3):S250-2. PMCID: PMC3183531. https://doi.org/10.4103/2230-8210.84878.. Katznelson L, Laws E, Melmed S, et al. Acromegaly: An endocrine society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(11):3933-51. PMID: 25356808. https://doi.org/10.1210/jc.2014-2700.. Mercado M, Borges F, Bouterfa H, et al. A prospective, multicenter study to investigate the efficacy, safety and tolerability of octreotide LAR (long-acting ...http://www.asean-endocrinejournal.org/index.php/JAFES/article/view/419
Gene Expression Signature in Adipose Tissue of Acromegaly Patients. | mrc2
To study the effect of chronic excess growth hormone on adipose tissue, we performed RNA sequencing in adipose tissue biopsies from patients with acromegaly (n = 7) or non-functioning pituitary adenomas (n = 11). The patients underwent clinical and metabolic profiling including assessment of HOMA-IR. Explants of adipose tissue were assayed ex vivo for lipolysis and ceramide levels. Patients with acromegaly had higher glucose, higher insulin levels and higher HOMA-IR score. We observed several previously reported transcriptional changes (IGF1, IGFBP3, CISH, SOCS2) that are known to be induced by GH/IGF-1 in liver but are also induced in adipose tissue. We also identified several novel transcriptional changes, some of which may be important for GH/IGF responses (PTPN3 and PTPN4) and the effects of acromegaly on growth and proliferation. Several differentially ...http://mrc2.umich.edu/node/9
NewYork-Presbyterian/Queens - Acromegaly
Treatment of acromegaly depends on the cause of the disease. More than 95 percent of acromegaly cases are caused by benign tumors on the pituitary gland. Because the tumor is compressing the pituitary gland, the hormone production can be altered by removing or reducing the size of the tumor. Some other acromegaly cases are caused by tumors of the pancreas, lungs, or adrenal glands.. The goal of treatment is to restore the pituitary gland to normal function, producing normal levels of growth hormone.. Treatment may include removal of the tumor, radiation therapy, and use of a growth hormone-blocking drug.. Left untreated, acromegaly can lead to diabetes mellitus and hypertension. The disease also increases a patient's risk ...http://www.nyhq.org/diw/content.asp?PageID=P00396&More=DIW
Diagnosis and management of acromegaly : the patient's perspective
PURPOSE:. Early diagnosis is a success factor for the prevention of long-term comorbidity and premature death in patients with acromegaly, but large-scale data on the diagnostic process and disease management are scarce. Therefore, we aimed to evaluate the diagnostic process, implementation of treatment and changes in life situation in patients with acromegaly, focusing on sex-specific differences.. METHODS:. Non-interventional patient-reported outcome study. 165 patients with clinically and biochemically proven acromegaly were questioned about the diagnostic process and utilization of health care by means of a self-developed standardized postal survey including questions on acromegaly symptoms experienced before diagnosis, number and specialty of consulted doctors, time to diagnosis and aftercare.. RESULTS:. The diagnostic process took 2.9 (SD 4.53) years, during which 3.4 ...http://uu.diva-portal.org/smash/record.jsf?pid=diva2:901320
Safety and Efficacy of Octreotide Long Acting Release (LAR) in Treatment Naïve Acromegalic Patients - Full Text View -...
Currently, the first line treatment for acromegaly is surgery, in order to remove the adenoma causing overproduction of growth hormone which leads to acromegaly. Octreotide LAR is approved for treatment of acromegaly after surgery if the disease is not controlled. This study was aimed to test the safety and efficacy of octreotide LAR in acromegalic patients who did not have any previous treatment for acromegaly ...https://clinicaltrials.gov/show/NCT00128232
Acromegaly definition, history, causes, symptoms, treatment of acromegaly
Acromegaly: Definition and history, causes, signs and symptoms of acromegaly. Treatment, radiotherapy, and homeopathic medicines for acromegaly treatment.https://treatment.hpathy.com/homeo-medicine/homeopathy-acromegaly/
Pulmonary epidermoid carcinoma in a patient with acromegaly: a rare entity
A 56-years-old woman was referred to our unit for partially treated acromegaly. She had a high level of insulin growth factor. She did not complain of any pulmonary symptoms and was a non-smoker. Physical examination revealed clinical features of acromegaly. She had a 13 mm pituitary adenoma and was proposed for surgical intervention. Her chest X-ray showed a right paracardiac tumor. Computed tomography scan revealed a large right-sided fowler tumor. Pituitary surgery was cancelled and lobectomy after biopsy with lymph nodes excision was performed through thoracotomy. Histological study of the tumor revealed a medium differentiated epidermoid carcinoma with positive lymph nodes and extension to pleura. She was referred to chemotherapy protocol. Association between carcinoma and acromegaly has previously been reported. Most common tumors are colorectal and ...http://www.panafrican-med-journal.com/content/article/12/27/full/
Treatment of acromegaly patients at the Federal University of Triângulo Mineiro (UFTM): Experience Report - Semantic Scholar
OBJECTIVE: To evaluate the effectiveness of the treatment of acromegaly patients at the Federal University of Triangulo Mineiro. METHODS: Cross-sectional and retrospective study of thirty cases treated over a period of two decades. RESULTS: 17 men (56.7%) aged 14-67 years and 13 women aged 14-86 years were analyzed. Twenty-one patients underwent transphenoidal surgery, whichwas associated with somatostatin receptor ligands in 11 patients (39.3%), somatostatin receptor ligands + radiotherapyin 5 patients (17.8%), radiotherapy in 3 patients (10.7%), and radiotherapy + somatostatin receptorligands + cabergoline in 1 patient (3.6%). Additionally, 2 patients underwent radiotherapy and surgeryalone. Six patients received somatostatin receptor ligands before surgery, and 2 were not treated due to refusal and death. Nine patients have died, and 20 are being followed; 13 (65%) have growth hormonelevels o1 ng/mL, and 11 have normal insulin-like ...https://www.semanticscholar.org/paper/Treatment-of-acromegaly-patients-at-the-Federal-Un-Borges-Lara/cc68868df9ef485e062b41629a86fe9d0da26df9
RheumaKnowledgy » Acromegaly
ICD-10 Code: E22.0. Definition: Acromegaly is caused by overproduction of growth hormone, most commonly by a benign pituitary tumor (pituitary adenoma). Acromegaly may be accompanied by distinct findings in the musculoskeletal system that may contribute to early detection and diagnosis.. Cardinal Findings: Excess growth hormone causes acromegaly in adults and, if the onset is before epiphyseal closure, gigantism in children. Clinically, patients develop distinctive coarse facial features; thickening of the skin; enlarged mandible, hands, and feet; prominent forehead and supraorbital ridging; enlarged tongue and enlarged viscera; hirsutism; oily skin; and excessive sweating. The musculoskeletal complaints result from premature osteoarthritis, kyphosis of the spine, pseudogout, entrapment neuropathies [e.g., ...http://www.rheumaknowledgy.com/acromegaly/
The Effective Use of Radiosurgery in the Treatment of Acromegaly | California Center for Pituitary Disorders
Transsphenoidal surgery remains the treatment of choice for most patients with acromegaly. Optimal management of the 10 to 50% of patients who do not undergo remission after transsphenoidal surgery and the 20% of patients who experience recurrence of acromegaly after initial transsphenoidal surgery remains less clear. Radiation represents an evolving treatment for acromegaly that warrants consideration as an alternative to medical therapy for cases refractory to transsphenoidal surgery.. Two main types of radiation have been investigated: conventional fractionated radiotherapy and stereotactic radiosurgery. Conventional fractionated radiotherapy in doses of 160-180 cGray (cGy) 4 to 5 times per week over 5 to 6 weeks to a total dose of 45-50 Gy has been used since 1980, and most studies report remission rates of 35 to 75%. Remission takes 10 years to achieve and rates of hypopituitarism range from 50 to 80% ...http://ccpd.ucsf.edu/news/effective-use-radiosurgery-treatment-acromegaly
Acromegaly | California Center for Pituitary Disorders
In acromegaly, elevated growth hormone causes an increase in shoe and ring size, enlargement of the mandible leading to an underbite, frontal bossing, and enlargement of the nose.. These changes are usually very gradual and may be missed by the patient and their family for many years. Soft tissue within the body can also enlarge, causing increased snoring, sleep apnea, chronic sinus problems, radiculopathy from nerve root entrapment (i.e., carpal tunnel syndrome), joint pain and stiffness, increase in sweating (hyperhydrosis), and even changes in voice and body odor.. Patients with acromegaly may have accelerated cardiovascular disease and thickening (hypertrophy) of the heart muscles, diabetes, and an increased risk of colon polyps. Many of the changes related to acromegaly reverse once the growth hormone and IGF-1 levels are normalized; ...http://ccpd.ucsf.edu/pituitary-disorders/tumors/acromegaly
Treatment of acromegaly improves quality of life, measured by AcroQol. - The Christie Research Publications Repository
BACKGROUND: AcroQol is a disease-generated questionnaire, developed to assess quality of life (QOL) in patients with acromegaly. We have previously demonstrated severely impaired QOL in patients with acromegaly and the value of AcroQol in measuring QOL in a cross-sectional study compared with the non-disease-specific generic tools 'Psychological general wellbeing schedule' (PGWBS) and EuroQol (EQ-5D), and the disease-specific signs and symptoms score (SSS). AIM, SUBJECTS AND METHODS: We re-evaluated these tools in a longitudinal study of 56 of the previously reported patients (33 male, mean age 55 +/- 15 years), in order to determine change in QOL over time and the effect of different treatment modalities. Data were analysed using Spearman's correlation tests. RESULTS: Baseline median IGF-I was 354 ng/ml (range 48-899) and at re-evaluation 217 ng/ml (60-594) (P , 0.001) [median time interval 608 days (113-1136)]. Analysis of change in IGF-I ...http://christie.openrepository.com/christie/handle/10541/71973
... is a hormonal disorder that results from the pituitary gland producing too much growth hormone (GH). It is most often diagnosed in middle-aged adults, although symptoms can appear at any age. Signs and symptoms include abnormal growth and swelling of the hands and feet; bone changes that alter various facial features; arthritis; carpal tunnel syndrome; enlargement of body organs; and various other symptoms. The condition is usually caused by benign tumors on the pituitary called adenomas. Rarely, it is caused by tumors of the pancreas, lungs, and other parts of the brain. Acromegaly is usually treatable but when left untreated, it can result in serious illness and premature death. When GH-producing tumors occur in childhood, the disease that results is called gigantism rather than acromegaly ...http://diseaseinfosearch.org/Acromegaly/162
Acromegaly - Loyola University Health System
Surgery to remove the pituitary tumor that is causing this condition often corrects the abnormal GH. Sometimes, the tumor is too large to be removed completely and acromegaly is not cured. In this case, medicines and radiation (radiotherapy) may be used to treat acromegaly. Some people with tumors that are too complicated to remove by surgery are treated with medicines instead of surgery. After treatment, you will need to see your provider regularly to make sure that the pituitary gland is working normally and that acromegaly does not come back. Yearly evaluations are recommended. ...http://loyolauniversity.adam.com/content.aspx?productId=101&pid=1&gid=000321
The Metabolic Profile in Active Acromegaly is Gender-Specific. | IRIS Università degli Studi di Palermo
CONTEXT: The sexual dimorphism of the somatotroph axis has been documented, but whether the acromegaly-related metabolic alterations are gender-dependent has never been investigated. OBJECTIVE: The aim of the study was to evaluate the impact of gender on the metabolic parameters in acromegaly. DESIGN: We conducted a retrospective, comparative, multicenter study. PATIENTS: The 307 newly diagnosed acromegalic patients included in the study were grouped by gender: 157 men (aged 48.01 ± 14.28 yr), and 150 women (aged 48.67 ± 14.95 yr; of which 77 were premenopausal and 73 postmenopausal). OUTCOME MEASUREMENTS: We measured each component of the metabolic syndrome (MS), hemoglobin A1c, the areas under the curve (AUCs) of glucose and insulin during 2-h oral glucose tolerance test, basal insulin resistance using the homeostasis model assessment of the insulin resistance index, stimulated insulin sensitivity using the insulin sensitivity index, early ...https://iris.unipa.it/handle/10447/72924
IGF(CA)19 and IGFBP-3-202A/C gene polymorphism in patients with acromegaly
Aims: We aimed to investigate IGF1 and IGFBP3 gene polymorphisms in patients with acromegaly.. Methods: We included 34 patients with acromegaly and 37 healthy subjects to study. At baseline examinations, antropometric measurements were done. Genomic DNA from the patients and controls were prepared. Serum, glucose, insulin, total cholesterol, triglyceride, HDL-cholesterol, LDL-cholesterol, GH, IGF1 and IGFBP3 levels of subjects were analyzed.. Results: The frequency of genotype IGF1(CA)19 and IGFBP3-202 A/C gene was significantly different between control and patients. In acromegalic patients, a significant difference in the serum IGF1 levels and LDL cholesterol levels among the three IGF(CA)19 genotype. LDL levels were positively correlated with IGF1. Subjects having ,194 bp genotype had higher IGF1 and LDL cholesterol levels.We observed that the patients with 194 bp genotype have more invasive and bigger tumors and they require adjunctive ...http://www.endocrine-abstracts.org/ea/0022/ea0022p549.htm
Prospective Study on Changes in Acromegaly - Full Text View - ClinicalTrials.gov
Rationale: Acromegaly is the clinical syndrome that results from an excess of growth hormone (GH). Craniofacial and hand disproportions due to soft tissue swelling and new bone formation are highly prevalent in patients with active acromegaly. Besides the cosmetic aspects, these changes can impair the quality of life because of the significant morbidity with respect to oral, maxillofacial and hand pathologies as well as respiratory problems such as sleep apnea and changes in speech. At present it is unclear if these craniofacial and hand disproportions, sleep apnea and speech changes are (partially) reversible after successful treatment. Therefore there is no consensus about the information patients should be given about (partial) recovery of facial and hand disproportions after treatment and how the follow-up with respect to oral, maxillofacial, respiratory and hand pathology should be ...https://clinicaltrials.gov/ct2/show/NCT01612624?recr=Open&cond=%22Acromegaly%22&rank=15
Percent reduction of growth hormone levels correlates closely with percent resected tumor volume in acromegaly. - NextBio...
Correlation between tumor volume and hormone levels in individual patients would permit calculation of the fraction of tumor removed by surgery, by measuring postoperative hormone levels. The goals of this study were to examine the relationship between tumor volume, growth hormone (GH), and insulin-like growth factor-1 (IGF-1) levels, and to assess the correlation between percent tumor removal and the reduction in plasma GH and IGF-1 in patients with acromegaly. The 3D region of interest-based volumetric method was used to measure tumor volume via MRI before and after surgery in 11 patients with GH-secreting adenomas. The volume of residual tumor as a fraction of preoperative tumor volume was correlated with GH levels before and after surgery. Examination of this potential correlation required selection of patients with acromegaly who 1) had ...http://www.nextbio.com/b/search/article.nb?id=25423276
Increased Rate of Intracranial Saccular Aneurysms in Acromegaly: An MR Angiography Study and Review of the Literature.
Background: The concurrence of intracranial aneurysms and acromegaly has been reported and debated previously. Our study in a large number of patients aimed to verify whether acromegaly patients carry a higher risk of harboring intracranial saccularhttp://www.biomedsearch.com/nih/Increased-Rate-Intracranial-Saccular-Aneurysms/21307138.html