Acromegaly

Reviewed 06/2017
 


BASICS

  • Acromegaly is a rare endocrinologic disease characterized by excess secretion of growth hormone (GH), resulting in a syndrome of coarsened facial features and overgrowth of the hands and feet.

  • C...

DIAGNOSIS

HISTORY

  • Musculoskeletal

    • Enlarging shoe and ring size

    • Arthralgias/myalgias

  • Neurologic

    • Headache

    • Vision changes, particularly temporal hemianopsia

    • Hand numbness/carpal tunnel syndrome

    • Fatigue, weak...

TREATMENT

  • Transsphenoidal surgery is the initial treatment of choice for most patients with acromegaly of pituitary origin, particularly if the tumor compresses the optic chiasm.

  • Surgery is associated ...

ONGOING CARE

FOLLOWUP RECOMMENDATIONS

MONITORING

  • At baseline

    • Echocardiogram

    • Colonoscopy

  • Every 3 to 4 months

    • Cardiovascular exam and BP measurement

    • Measurement of serum IGF-1

  • Annually

    • MRI of pituitary sel...

REFERENCES

Holdaway IM, Rajasoorya C. Epidemiology of acromegaly. Pituitary.  1999;2(1):29–41. [View Abstract on OvidInsights]
Borson-Chazot F, Garby L, Raverot G et al. Acromegaly induced by ec...

ADDITIONAL READING

  • Dekkers OM, Biermasz NR, Pereira AM et al. Mortality in acromegaly: a metaanalysis. J Clin Endocrinol Metab.  2008;93(1):61–67. [View Abstract on OvidInsights]

  • Melmed S. Medical...

SEE ALSO

Algorithm: Tall Stature 

CODES

ICD10

E22.0 Acromegaly and pituitary gigantism 

ICD9

253.0 Acromegaly and gigantism 

SNOMED

  • 74107003 Acromegaly (disorder)

  • 240089002 Myopathy in acromegaly (disorder)

  • 230581008 Neuropathy in acromegaly...

PEARLS

  • The onset of acromegaly is insidious and may be initially subtle.

  • The serum IGF-1 level is the preferred screening test and is elevated in acromegaly.

  • An elevated IGF-1 should prompt an MRI of th...

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