Acromegaly: Overview and Current Management Options

Abstract

Growth-hormone-producing pituitary adenomas in adults will be the focus of this review acromegaly is a disorder caused by pathologically excess levels of growth hormone (GH), nearly always secondary to a pituitary somatotroph adenoma, which account for 10–20% of all pituitary adenomas. Acromegaly is a pan-systemic disease, including but not limited to effects of excess growth hormone on the cardiovascular, respiratory, gastrointestinal, metabolic, and reproductive systems. This raises the concern for clinicians and patients alike in diagnosing the underlying disease when multiple systems are involved. Numerous organ systems may be differentially affected, and the multiplicity of signs and symptoms possibly overlap with other conditions, with the typically slow progression of the disease, it may take years from the initiation of biochemical GH excess before a diagnosis of acromegaly is made. The goal of effective treatment of acromegaly is to eliminate hypersecretion of GH and normalize the production of IGF-1 while preserving normal pituitary function. Medication, radiotherapy, and surgery, often in combination, and over time, are required to mitigate, reduce, and eliminate the morbidity and excess, premature mortality caused by GH elevation.