Challenges in the diagnosis and management of acromegaly: a focus on comorbidities |
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Authors: | Alin Abreu,Alejandro Pinzón Tovar,Rafael Castellanos,Alex Valenzuela,Claudia Milena Gómez Giraldo,Alejandro Castellanos Pinedo,Doly Pantoja Guerrero,Carlos Alfonso Builes Barrera,Humberto Ignacio Franco,Antônio Ribeiro-Oliveira Suffix" >Jr.,Lucio Vilar,Raquel S. Jallad,Felipe Gaia Duarte,Mônica Gadelha,Cesar Luiz Boguszewski,Julio Abucham,Luciana A. Naves,Nina Rosa C. Musolino,Maria Estela Justamante de Faria,Ciliana Rossato,Marcello D. Bronstein |
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Affiliation: | 1.Endocrinology Unit,Centro Médico Imbanaco Cali,Cali,Colombia;2.Internal Medicine Department, Hospital of Neiva,University Surcolombiana,Neiva,Colombia;3.Internal Medicine Department,University Industrial of Santander,Bucaramanga,Colombia;4.Department of Internal Medicine, Endocrinology Fundación Cardio-Infantil, Instituto de Cardiología,Universidad del Rosario,Bogotá,Colombia;5.Endocrinology Unit,Hospital Universitario San Ignacio,Bogotá,Colombia;6.Internal Medicine Department,Hospital San Jerónimo de Montería,Montería, Córdoba,Colombia;7.Endocrinology Unit, Hospital Universitario Departamental de Nari?o, CENTRO de Endocrinologia CENDOO,Universidad Nacional de Colombia,Pasto,Colombia;8.Endocrinology Department, Hospital Universitario San Vicente Fundación,Universidad de Antioquia,Medellín,Colombia;9.Endocrinology Faculty,Universidad Caldas,Manizales,Colombia;10.Federal University of Minas Gerais,Belo Horizonte,Brazil;11.Endocrinology and Chair, Division of Endocrinology, Hospital das Clínicas,Pernambuco Federal University Medical School,Recife,Brazil;12.Neuroendocrine Unit, Division of Endocrinology and Metabolism, Hospital das Clínicas,University of S?o Paulo Medical School,S?o Carlos,Brazil;13.Endocrine Section, Medical School and Hospital Universitário Clementino Fraga Filho,Universidade Federal do Rio de Janeiro,Rio de Janeiro,Brazil;14.Department of Internal Medicine, Endocrine Division (SEMPR),Federal University of Paraná,Curitiba,Brazil;15.Neuroendocrine Unit, Escola Paulista de Medicina,Universidade Federal de S?o Paulo,S?o Paulo,Brazil;16.Department of Endocrinology, Faculty of Medicine,University of Brasilia,Brasília,Brazil;17.Neuroendocrine Unit, Division of Neurosurgery, Hospital das Clínicas,University of Sao Paulo School of Medicine,S?o Paulo,Brazil;18.Department of Odontology, Central Unit, Hospital das Clínicas,University of Sao Paulo School of Medicine,S?o Paulo,Brazil |
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Abstract: | IntroductionAcromegaly is a rare, insidious disease resulting from the overproduction of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), and is associated with a range of comorbidities. The extent of associated complications and mortality risk is related to length of exposure to the excess GH and IGF-1, thus early diagnosis and treatment is imperative. Unfortunately, acromegaly is often diagnosed late, when patients already have a wide range of comorbidities. The presence of comorbid conditions contributes significantly to patient morbidity/mortality and impaired quality of life.MethodsWe conducted a retrospective literature review for information relating to the diagnosis of acromegaly, and its associated comorbidities using PubMed. The main aim of this review is to highlight the issues of comorbidities in acromegaly, and to reinforce the importance of early diagnosis and treatment.Findings and conclusionsSuccessful management of acromegaly goes beyond treating the disease itself, since many patients are diagnosed late in disease evolution, they present with a range of comorbid conditions, such as cardiovascular disease, diabetes, hypertension, and sleep apnea. It is important that patients are screened carefully at diagnosis (and thereafter), for common associated complications, and that biochemical control does not become the only treatment goal. Mortality and morbidities in acromegaly can be reduced successfully if patients are treated using a multimodal approach with comprehensive comorbidity management. |
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