Acromegaly in practice of clinician: modern aspects of diagnosis and treatment


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Abstract

Acromegaly is a severe neuroendocrine disease leading to different complications, affecting all organs and body systems. The disease is characterized by progressive disability and shortened life expectancy. The mortality of patients with acromegaly in the absence of timely diagnosis and adequate treatment exceeds the general population level by almost 10 times, and increases with the duration of the disease; the same is applicable to the cardiovascular mortality of patients with acromegaly [1]. Over the past decade, a large number of data on prevalence, clinical manifestations, diagnostic tests and effective approaches to the treatment of this disease have appeared. But, despite this, acromegaly is more often diagnosed already at the stage of development of complications. For the timely diagnosis of the disease in the early stages, it would be nice to expand the insight of therapists and other physicians into the aspects of diagnosing this serious disease, approaches to treatment and monitoring the effectiveness of the therapy.

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About the authors

Tatiana Yu. Demidova

N.I. Pirogov Russian National Research Medical University

Email: t.y.demidova@gmail.com
MD, professor, head of the Department of endocrinology

Daria V. Skuridina

N.I. Pirogov Russian National Research Medical University

Email: shurpesha@mail.ru
assistant of the Department of endocrinology

References

  1. Дедов И.И., Молитвословова Н.Н., Рожинская Л.Я., Мельниченко Г.А. Федеральные клинические рекомендации по клинике, диагностике, дифференциальной диагностике и методам лечения акромегалии. Проблемы эндокринологии. 2013;59(6):4-18.
  2. Reid T.J., Post K.D., Bruce J.N., Nabi Kanibir M., Reyes-Vidal C.M., Freda P.U. Features at diagnosis of 324 patients with acromegaly did not change from 1981 to 2006: acromegaly remains under-recognized and under-diagnosed. Clin. Endocrinol. (Oxf) 2010;72(2):203-8.
  3. Katznelson L., Laws E.R. Jr, Melmed S., Molitch M.E., Murad M.H., Utz A., Wass J.A. Acromegaly: an endocrine society clinical practice guideline. Endocrine Society. J. Clin. Endocrinol. Metab. 2014;99(11):3933-51.
  4. Rosario P.W. Frequency of acromegaly in adults with diabetes or glucose intolerance and estimated prevalence in the general population. Pituitary. 2011;14(3):217-21.
  5. Fernandez A., Karavitaki N., Wass J.A. Prevalence of pituitary ademonas: a community-based, cross-sectional study in Banbury. Clin. Endocrinol. (Oxf) 2010;72(3):377-82.
  6. Древаль А.В., Виноградова А.В., Перфильев А.В., Триголосова И.В., Иловайская И.А. Эффективность лечения акромегалии сандостатином ЛАР в дозах 10-40 мг. Фарматека. 2011;11:75-9.
  7. Schneider H.J., Kosilek R.P., Gunther M., Roemmler J., Stalla G.K., Sievers C., Reincke M., Schopohl J., Würtz R.P. A novel approach to the detection of acromegaly: accuracy of diagnosis by automatic face classification. J. Clin. Endocrinol. Metab. 2011;96(7):2074-80.
  8. Fieffe S., Morange I., Petrossians P., Chanson P., Rohmer V., Cortet C., Borson-Chazot F., Brue T., Delemer B. Diabetes in acromegaly, prevalence, risk factors, and evolution: data from the French Acromegaly Registry. Eur. J. Endocrinol. 2011;164(6):877-84.
  9. Dreval A.V., Trigolosova I.V., Misnikova I.V., Kovalyova Y.A., Tishenina R.S., Barsukov I.A., Vinogradova A.V., Wolffenbuttel B.H. Prevalence of diabetes mellitus in patients with acromegaly. Endocr. Connect. 2014;3(2):93-8.
  10. Killinger Z., Payer J., Lazurova I., Imrich R., Homerova Z., Kuzma M., Rovensky J. Arthropathy in acromegaly. Rheum. Dis. Clin. North Am. 2010;36(4):713-20.
  11. Mazziotti G., Biagioli E., Maffezzoni F., Spinello M., Serra V., Maroldi R., Floriani I., Giustina A. Bone turnover, bone mineral density and fracture risk in acromegaly: a meta-analysis. J. Clin. Endocrinol. Metab. 2015;100(2):384-94.
  12. Arosio M., Reimondo G., Malchiodi E., Berchialla P., Borraccino A., De Marinis L., Pivonello R., Grottoli S., Losa M., Cannavo S., Minuto F., Montini M., Bondanelli M., De Menis E., Martini C., Angeletti G., Velardo A., Peri A., FaustinFustini M., Tita P., Pigliaru F., Borretta G., Scaroni C., Bazzoni N., Bianchi A., Appetecchia M., Cavagnini F., Lombardi G., Ghigo E., BeckPeccoz P., Colao A., Terzolo M.; Italian Study Group of Acromegaly. Predictors of morbidity and mortality in acromegaly: an Italian survey. Eur. J. Endocrinol. 2012;167(2):189-98.
  13. Kamenicky P., Blanchard A., Frank M., Salenave S., Letierce A., Azizi M., Lombès M., Chanson P. Body fluid expansion in acromegaly is related to enhanced epithelial sodium channel (EnaC) activity. J. Clin. Endocrinol. Metab. 2011;96(7):2127-35.
  14. Lombardi G., Di Somma C., Grasso L.F., Savanelli M.C., Colao A., Pivonello R. The cardiovascular system in growth hormone excess and growth hormone deficiency. J. Endocrinol. Invest. 2012;35(11):1021-9.
  15. Powlson A.S., Gurnell M. Cardiovascular disease and sleep-disordered breathing in acromegaly. Neuroendocrinology. 2016;103(1):75-85.
  16. Иловайская И.А. Акромегалия: как на поликлиническом приеме узнать редкое заболевание? Поликлиника. 2015;3:22-7.
  17. Roemmler J., Gutt B., Fischer R., Vay S., Wiesmeth A., Bidlingmaier M., Schopohl J., Angstwurm M. Elevated incidence of sleep apnoea in acromegaly-correlation to disease activity. Sleep Breath. 2012;16(4):1247-53.
  18. Олейник О.В., Молитвословова Н.Н. Проблемы эндокринологии. 2013;59(5):42-6.
  19. Rosemary D., Paul M.S., Mark S. Acromegaly. Oxford University Press. 2016. 32 р.
  20. Молитвословова Н.Н. Акромегалия. Клиническая нейроэндокринология под ред. И.И. Дедова. 2011:137-69.
  21. Старостина Е.Г., Бобров А.Е., Александрова М.М. Виды и распространенность психических расстройств у больных акромегалией. РМЖ. 2017;25(1):18-23.
  22. Акромегалия: патогенез, клиника, диагностика, дифференциальная диагностика, методы лечения. Под ред. И.И. Дедова, Г.А. Мельниченко. М.: УП Принт, 2012. 79 с.
  23. Grasso L.F., Pivonello R., Colao A. Somatostatin analogs as a first-line treatment in acromegaly: when is it appropriate? Curr. Opin. Endocrinol. Diabetes Obes. 2012;19(4):288-94.
  24. Shin S.S., Tormenti M.J., Paluzzi A., Rothfus W.E., Chang Y.F., Zainah H., Fernandez-Miranda J.C., Snyderman C.H., Challinor S.M., Gardner P.A. Endoscopic endonasal approach for growth hormone secreting pituitary adenomas: outcomes in 53 patients using 2010 consensus criteria for remission. Pituitary. 2013;16(4):435-44.
  25. Starke R.M., Raper D.M., Payne S.C., Vance M.L., Oldfield E.H., Jane J.A. Jr. Endoscopic vs microsurgical transsphenoidal surgery for acromegaly: outcomes in a concurrent series of patients using modern criteria for remission. J. Clin. Endocrinol. Metab. 2013;98:3190-8.
  26. Wilson T.J., McKean E.L., Barkan A.L., Chandler W.F., Sullivan S.E. Repeat endoscopic transsphenoidal surgery for acromegaly: remission and complications. Pituitary. 2013;16:459-64.
  27. Levy M.J. The association of pituitary tumors and headache. Curr. Neurol. Neurosci. Rep. 2011;1 1:164-70.
  28. Caron P.J., Bevan J.S., Petersenn S., Flanagan D., Tabarin A., Prévost G., Maisonobe P., Clermont A.; PRIMARYS Investigators. Tumor shrinkage with lanreotide autogel 120 mg as primary therapy in acromegaly: results of a prospective multicenter clinical trial. J. Clin. Endocrinol. Metab. 2014;99:1282-90.
  29. Melmed S., Cook D., Schopohl J., Goth M.I., Lam K.S., Marek J. Rapid and sustained reduction of serum growth hormone and insulin-like growth factor-1 in patients with acromegaly receiving lanreotide autogel therapy: a randomized, placebo-controlled, multicenter study with a 52 week open extension. Pituitary. 2010;13:18-28.
  30. Giustina A., Mazziotti G., Torri V., Spinello M., Floriani I., Melmed S. Meta-analysis on the effects of octreotide on tumor mass in acromegaly. PLoS One. 2012;7:e36411.
  31. Colao A., Bronstein M.D., Freda P., Gu F., Shen C.C., Gadelha M., Fleseriu M., van der Lely A.J., Farrall A.J., Hermosillo Reséndiz K., Ruffin M., Chen Y., Sheppard M.; Pasireotide C2305 Study Group. Pasireotide versus octreotide inacromegaly: a head-to-head superiority study. J. Clin. Endocrinol. Metab. 2014;99:791-9.
  32. Lee C.C., Vance M.L., Xu Z., Yen CP., Schlesinger D., Dodson B., Sheehan J. Stereotactic radiosurgery for acromegaly. J. Clin. Endocrinol. Metab. 2014;99:1273-81.
  33. Caron P.J. et al. Tumor Shrinkage with lanreotide Autogel 120 mg as primary therapy in acromegaly: results of a prospective multicenter clinical trial. // J Clin Endocrinolog Metab. 20014 Apr; 99(4): 1282-1290
  34. Caron P.J., Bevan J.S., Petersenn S. et al.; PRIMARYS Investigators Group. Effects of lanreotide Autogel primary therapy on symptoms and quality-of-life in acromegaly: data from the PRIMARYS study. Pituitary. 2016 Apr;19(2):149-57.
  35. Baroni et al. Italian society of the study of diabetes/Italian Endocrinological Society guidelines on the treatment of hyperglycemia on Cushing's syndrome and acromegaly J Endocrinol Invest (2016) 39: 235-255
  36. Древаль А.В. и др. Механизмы нарушений углеводного обмена при акромегалии в зависимости от лечения Проблемы эндокринологии 1, 2015 стр.23-30
  37. Caron P.J. Glucose and lipid levels with lanreotide autogel 120 mg in treatment-naïve patients with acromegaly: data from the PRIMARYS study Clinical Endocrinology 2016 doi: 10.1111/cen.13285

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