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Acromegaly — a novel view of the patient. Polish proposals for diagnostic and therapeutic procedures in the light of recent reports
open access
Abstract
is usually delayed and is often associated with the development of various complications causing premature mortality. In patients with hypertension, heart failure, diabetes, and arthropathy that is non-specific for age, attention should be paid to the occurrence of somatic signs of acromegaly. As a screening test, insulin-like growth factor-1 (IGF-1) concentration should be assessed. Further diagnostic and treatment procedures are possible in specialised centres. The first-line therapy is selective transsphenoidal adenomectomy. Patients with a good prognosis related to a surgical removal of the pituitary tumour should be referred only to centres experienced in performing this type of procedure, after pharmacological preparation. Other patients, and those who have not recovered after surgical treatment, should be subjected to long-term pharmacotherapy with long-acting somatostatin analogues. In each case, the complications of acromegaly should be followed-up long-term and actively treated. This proposed new recommendation should be helpful for the management of patients with acromegaly. (Endokrynol Pol 2014; 65 (4): 326–331)
Abstract
is usually delayed and is often associated with the development of various complications causing premature mortality. In patients with hypertension, heart failure, diabetes, and arthropathy that is non-specific for age, attention should be paid to the occurrence of somatic signs of acromegaly. As a screening test, insulin-like growth factor-1 (IGF-1) concentration should be assessed. Further diagnostic and treatment procedures are possible in specialised centres. The first-line therapy is selective transsphenoidal adenomectomy. Patients with a good prognosis related to a surgical removal of the pituitary tumour should be referred only to centres experienced in performing this type of procedure, after pharmacological preparation. Other patients, and those who have not recovered after surgical treatment, should be subjected to long-term pharmacotherapy with long-acting somatostatin analogues. In each case, the complications of acromegaly should be followed-up long-term and actively treated. This proposed new recommendation should be helpful for the management of patients with acromegaly. (Endokrynol Pol 2014; 65 (4): 326–331)
Keywords
acromegaly; diagnosis; therapy; guidelines


Title
Acromegaly — a novel view of the patient. Polish proposals for diagnostic and therapeutic procedures in the light of recent reports
Journal
Issue
Article type
Review paper
Pages
326-331
Published online
2014-08-29
Page views
2581
Article views/downloads
3288
DOI
10.5603/EP.2014.0045
Bibliographic record
Endokrynol Pol 2014;65(4):326-331.
Keywords
acromegaly
diagnosis
therapy
guidelines
Authors
Marek Bolanowski
Marek Ruchała
Wojciech Zgliczyński
Beata Kos-Kudła
Agata Bałdys-Waligórska
Grzegorz Zieliński
Tomasz Bednarczuk
Alicja Hubalewska-Dydejczyk
Grzegorz Kamiński
Bogdan Marek
Jacek Daroszewski
Ryszard Waśko
Andrzej Lewiński