ACROMEGALY - 03/09/11
Résumé |
Acromegaly, a somatic growth and proportion disorder first described by Marie in 1886,68 occurs with an annual incidence of approximately 1000 patients. Elevated levels of growth hormone and insulin-like growth factor 1 (IGF-1) are the hallmarks of this syndrome73 and are usually caused by growth hormone–secreting pituitary tumors or, rarely, extrapituitary disorders.71 Clinical manifestations of acromegaly include skeletal and soft-tissue growth and deformations, and cardiac, respiratory, neuromuscular, endocrine, and metabolic complications. The increased morbidity associated with elevated growth hormone levels requires early and aggressive control of the disease. Although surgery is considered the treatment of choice, complete macroadenoma resection, especially if invasive, is difficult even for the skilled surgeon, and there is a low rate of biochemical control. Pharmacologic treatment has assumed more importance in managing these patients using long-acting somatostatin analogues, dopamine agonists, and growth hormone receptor antagonists. This article reviews recent advances in ethiology, clinical manifestations, diagnosis, and treatment of acromegaly.
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| Address reprint requests to Shlomo Melmed, MD, Academic Affairs, Room 2015, Cedars-Sinai Medical Center, 8700 Beverly Boulevard, Los Angeles, CA 90048, e-mail: melmed@csmc.edu |
Vol 30 - N° 3
P. 565-583 - septembre 2001 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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