Acromegaly

Tient had received counseling over the past year

Ariel L. Barkan

2004

Scholarcy highlights

  • Tient had received counseling over the past year
  • Adrenal and thyroid function remain normal. She still has vague joint pain, but there was a complete resolution of headache, carpal tunnel syndrome, and depression
  • Is a chronic debilitating disease characterized by persistent GH and IGF-I hypersecretion
  • The patient presented here had multiple symptoms and signs related to acromegaly, including arthropathy, heart disease, goiter, headache, and soft tissue hypertrophy for many years before an astute physician made the correct diagnosis
  • For example, that during the GHRH-induced process of somatotroph hyperplasia, elevated plasma IGF-I may cause physiologic involution of hyperplastic GH-producing cells, while one cell develops a resistance to the negative feedback of IGF-I and continues to proliferate, giving rise to a monoclonal adenoma
  • In the majority of patients, acromegaly is due to a GH-producing pituitary tumor
  • Octreotide is the only effective therapy for a surgically incurable ectopic GHRH secretion by a carcinoid tumor

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