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Acromegaly

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Pituitary Adenomas

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Abstract

Acromegaly is a rare disease (updated estimated prevalence: 80–130 cases per million inhabitants) that is due to excessive production and exposure to growth hormone (GH), generally driven by a pituitary GH-secreting adenoma. Acromegaly is characterized by slowly progressive somatic disfigurement (mainly involving the face and extremities) and multiorgan/system impairment. The rheumatologic, cardiovascular, respiratory, metabolic, and tumoral consequences are prevalent and generally determine the prognosis. The diagnosis is confirmed by elevated and nonsuppressible serum GH concentrations and by increased levels of age- and sex-adjusted circulating insulin-like growth factor-I (IGF-I). Treatment aims at reducing clinical manifestations, normalizing GH and IGF-I levels and correcting (or preventing) pituitary tumor compression of surrounding tissues and preventing the incidence/worsening of disease-related comorbidities. Transsphenoidal resection of the pituitary adenoma is the treatment of choice. If surgery fails to correct GH/IGF-I hypersecretion, medical treatment using three drug classes (somatostatin receptor ligands, dopamine agonists, or the GH-receptor antagonist pegvisomant), alone or in combination, is successful in most cases. Radiotherapy is currently considered a third-line treatment. This multistep therapeutic strategy currently allows clinical/hormonal control in most patients. The effectiveness of the current approach is probably the reason why the life expectancy of patients with acromegaly currently seems to approach that of the general population. Despite better disease control, persistent sequelae may nonetheless persist and consistently impair the quality of life of patients affected by acromegaly.

The chapter has been endorsed by Prof. Vera Popovic, , University of Belgrade, Belgrade, Serbia

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  1. Université Paris-Saclay, Inserm, Physiologie et Physiopathologie Endocriniennes, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Service d’Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l’Hypophyse, Le Kremlin-Bicêtre, France

    Luigi Maione & Philippe Chanson

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    Gianluca Tamagno

  2. Cell Biology, Physiology and Immunology, University of Córdoba, Cordoba, Spain

    Manuel D. Gahete

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Maione, L., Chanson, P. (2022). Acromegaly. In: Tamagno, G., Gahete, M.D. (eds) Pituitary Adenomas. Springer, Cham. https://doi.org/10.1007/978-3-030-90475-3_5

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