Contemporary Management of Acromegaly: A Practical Approach

Abstract

AbstractAcromegaly is a rare, chronic disease that is, in more than 95% of cases, caused by a growth hormone (GH)-secreting pituitary adenoma. Overproduction of insulin-like growth factor-1 (IGF-1) due to GH hypersecretion leads to various clinical features characterized by somatic overgrowth, physical changes, multiple comorbidities, and increased mortality. The average age at diagnosis is 40 to 50 years, with no sex predilection. The mean delay in diagnosis is 4.5 to 5 years due to the insidious onset and slow clinical progression of the disease. The diagnosis is confirmed by increased levels of IGF-1 and insuppressible GH measured by an oral glucose tolerance test. Treatment is aimed at normalizing GH/IGF-1 levels and controlling tumor volume. Medical treatment and radiotherapy can be utilized when surgery fails to control GH/IGF-1 hypersecretion. This article aims to review recent updates in acromegaly diagnosis and treatment to raise awareness about acromegaly clinical presentation and management.