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    Acromegaly: unravelling a complex disease.

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    Authors
    O'Halloran, Domhnall J
    Shalet, Stephen M
    Affiliation
    Department of Endocrinology, Christie Hospital NHS Trust, Manchester, UK.
    Issue Date
    1995-09
    
    Metadata
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    Abstract
    Acromegaly is a rare endocrine disorder characterized by growth hormone hypersecretion and is usually caused by a pituitary macroadenoma. It is associated with significantly increased patient morbidity and mortality. Molecular biological studies have implicated a causative role for oncogenic mutations (activating Gs alpha mutations and/or chromosomal 11q13 deletions) in less than 50% of cases. The cause(s) in the remaining 50% is speculative. Epidemiological evidence indicates that biochemical cure is achieved when mean GH levels are 5mU/l or less during a day-profile. This GH value correlates well with that required to normalize the serum IGF-1 concentration, a GH-dependent peptide which can be used to monitor the disease activity in acromegaly. Treatment must be carried out under the supervision of a dedicated endocrinologist and tailored to patients needs. The success of any treatment modality (surgery/pituitary irradiation/medical) depends on adenoma size and the extent of pretreatment GH hypersecretion. A combination of therapies is usually required to achieve satisfactory control of adenoma growth and GH hypersecretion. Octreotide, a synthetic analogue of native somatostatin, is particularly effective in controlling GH hypersecretion in this condition and the widespread introduction of a long-acting depot preparation is eagerly awaited. The development of true GH deficiency as a result of treatment is potentially worrying in view of its possible contribution to the increased incidence of cardiovascular mortality associated with hypopituitarism.
    Citation
    Acromegaly: unravelling a complex disease. 1995, 5 (3):119-24 Growth Regul
    Journal
    Growth Regulation
    URI
    http://hdl.handle.net/10541/98844
    PubMed ID
    7580862
    Type
    Article
    Language
    en
    ISSN
    0956-523X
    Collections
    All Christie Publications

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