Acromegaly

Acromegaly is the combination of clinical signs and symptoms resulting from growth hormone hypersecretion. The term acromegaly was popularized by Pierre Marie in 1886, and reflects the fact that a key feature of the disease is enlargement of the face, hands, and feet (1). The presence of an enlarged pituitary or pituitary adenoma in acromegaly was noted by several investigators, but it wasn't until 1892 that Massalongo proposed a causal relationship between the two (2). The demonstration by Cushing in 1909 that acromegaly improves after partial hypophysectomy confirmed the pituitary source of the disease (3). Cushing correctly postulated that overproduction of a growth-promoting substance by the pituitary was the underlying cause of many of the clinical signs and symptoms of acromegaly (4).

This section of the site provides information about acromegaly, including:

Overview of Acromegaly Treatment

  • While surgery remains the treatment of choice, the role of pharmacologic agents has expanded as the need for tight biochemical control becomes clear (5).
  • Long-acting somatostatin analogues, such as Sandostatin LAR® Depot (octreotide acetate for injectable suspension), remain the mainstay of medical therapy, as highlighted in recent acromegaly treatment guidelines (PDF 93KB) published by the American Association of Clinical Endocrinologists (AACE) (6).
Changing Features in Acromegaly Over Time
Acromegaly Pictures and Sandostatin LAR Depot (octreotide acetate)
Acromegaly causes gradual changes in facial features. Over a period of about 10 years, the woman pictured developed enlargement of the lips and nose, as well as other facial soft tissue. With curative transsphenoidal surgery, these changes were partially reversed.
References
  1. Lancranjan I, Bruns C, Grass P, et al, Sandostatin LAR®: pharmacokinetics, pharmacodynamics, efficacy, and tolerability in acromegalic patients. Metabolism. 1995;44(Suppl 1):18-26.
  2. Sandostatin LAR® Depot (octreotide acetate for injectable suspension) prescribing information. 2004, East Hanover, NJ.
  3. Jane JA, Jr., Thapar K, Laws ER, Jr., Acromegaly: historical perspectives and current therapy. J Neurooncol. 2001;54(2):129-37.
  4. Giustina A, Barkan A, Casanueva FF, et al, Criteria for cure of acromegaly: a consensus statement. J Clin Endocrinol Metab. 2000;85(2):526-9.
  5. Ben-Shlomo A, Melmed S, Acromegaly. Endocrinol Metab Clin North Am. 2001;30(3):565-83, vi.
  6. AACE Medical Guidelines for Clinical Practice for the diagnosis and treatment of acromegaly. Endocr Pract. April 2004;10(3):213-25.
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For more information

View more pictures of the physical signs of acromegaly.

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