Challenges in the diagnosis and management of acromegaly: a focus on comorbidities

Introduction: Acromegaly is a rare, insidious disease resulting from the overproduction of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), and is associated with a range of comorbidities. The extent of associated complications and mortality risk is related to length of exposure to the excess GH and IGF-1, thus early diagnosis and treatment is imperative. Unfortunately, acromegaly is often diagnosed late, when patients already have a wide range of comorbidities. The presence of comorbid conditions contributes significantly to patient morbidity/mortality and impaired quality of life. Methods: We conducted a retrospective literature review for information relating to the diagnosis of acromegaly, and its associated comorbidities using PubMed. The main aim of this review is to highlight the issues of comorbidities in acromegaly, and to reinforce the importance of early diagnosis and treatment. Findings and conclusions: Successful management of acromegaly goes beyond treating the disease itself, since many patients are diagnosed late in disease evolution, they present with a range of comorbid conditions, such as cardiovascular disease, diabetes, hypertension, and sleep apnea. It is important that patients are screened carefully at diagnosis (and thereafter), for common associated complications, and that biochemical control does not become the only treatment goal. Mortality and morbidities in acromegaly can be reduced successfully if patients are treated using a multimodal approach with comprehensive comorbidity management. © 2016, The Author(s).

• Fecha de publicación: 2016
• Institución: Universidad del Rosario
• Repositorio: Repositorio EdocUR - U. Rosario
• Idioma: eng
• OAI Identifier: oai:repository.urosario.edu.co:10336/22816
• Acceso en línea: https://doi.org/10.1007/s11102-016-0725-2; https://repository.urosario.edu.co/handle/10336/22816
• Palabra clave: Growth hormone; Somatomedin c; Acromegaly; Arthropathy; Cardiovascular disease; Comorbidity; Craniofacial development; Endocrine disease; Hormone synthesis; Human; Lung disease; Malignant neoplastic disease; Mental disease; Metabolic disorder; Morbidity; Mortality; Neurologic disease; Priority journal; Quality of life; Retrospective study; Review; Rheumatic disease; Adenoma; Cardiovascular diseases; Carpal tunnel syndrome; Comorbidity; Complication; Diabetes mellitus; Disease management; Growth hormone-secreting pituitary adenoma; Headache; Heart failure; Hypertension; Macroglossia; Osteoarthritis; Prognosis; Sleep apnea syndromes; Vision disorders; Adenoma; Cardiovascular diseases; Carpal tunnel syndrome; Comorbidity; Diabetes mellitus; Disease management; Growth hormone-secreting pituitary adenoma; Headache; Heart failure; Humans; Hypertension; Macroglossia; Osteoarthritis; Prognosis; Sleep apnea syndromes; Vision disorders; Acromegaly comorbidities; Acromegaly diagnosis; Latin america; left ventricular; left ventricular; Hypertrophy; Hypertrophy
• License: Abierto (Texto Completo)