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Chapter 14 – Acromegaly

Shlomo Melmed

  Pathogenesis
  Excess Growth Hormone Secretion
  Excess Growth Hormone–Releasing Hormone Secretion
  Role of the Hypothalamus in the Etiology of Acromegaly
  Intrinsic Pituitary Lesions
  Candidate Genes in the Etiology of Acromegaly
  Epidemiology of Acromegaly

  Diagnosis
  Documenting Growth-Hormone Hypersecretion
  Localizing the Source of Excess Growth Hormone
  Clinical Manifestations
  Laboratory Findings
  Mortality

  Management
  Treatment Goals
  Surgery
  Pituitary Irradiation
  Pharmacologic Management

  Integrated Treatment Approach to the Management of Acromegaly
  Patients With Likelihood of Good Surgical Outcome
  Patients With a Poor Likelihood of Successful Surgical Outcome
  Follow-Up
  General

Acromegaly is a disease of spectacular growth and metabolic disorders that has fascinated physicians for centuries. The natural history of the disorder, if left untreated, results in gross acral and facial disfigurement, musculoskeletal disability, cardiac failure, respiratory dysfunction, diabetes, and …