Munson Health
 
Acromegaly

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by Alan R
 

Causes

The pituitary gland is a small gland located at the base of the brain. It produces many hormones, including GH.
In most cases, the elevation of GH is caused by a benign tumor of this gland. In a small number of cases, cancerous tumors of other organs, such as the pancreas, adrenal, or lung, may be the source of excess GH.
Pituitary Gland
Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.
 

Treatment

The goals of treatment are to:
  • Reduce production of GH to normal levels
  • Stop and reverse the symptoms caused by excess GH
  • Correct other endocrine abnormalities, such as thyroid, adrenal, and sex organs
  • Reduce the tumor size
Treatment may include:

Surgery

The tumor that is believed to be causing acromegaly may be removed. In most cases, this is the preferred treatment. However, drug treatment is increasing in popularity.

Radiotherapy

In adults, external beams of radiation are used to shrink the tumor. It is most often used when surgery cannot be used or when medications have failed.

Medication

Drugs may be given to reduce the level of GH. These include:
  • Cabergoline
  • Pergolide
  • Bromocriptine—may be given before surgery to shrink tumor
  • Octreotide—may be the most effective medication for this condition
  • Pegvisomant—used if other treatments have failed
 

RESOURCES

National Institute of Diabetes & Digestive & Kidney Diseases
http://www.niddk.nih.gov

Pituitary Network Association
http://www.pituitary.org

 

CANADIAN RESOURCES

Canadian Society of Endocrinology & Metabolism
http://www.endo-metab.ca

Health Canada
http://www.hc-sc.gc.ca

 

References


Abrams P, Alexopoulou O, Abs R, et al. Optimalization and cost management of lanreotide-Autogel therapy in acromegaly. Eur J Endocrinol . 2007;571-577.


Acromegaly. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated November 7, 2012. Accessed July 26, 2013.


Acromegaly treatment consensus workshop participants: guidelines for acromegaly management. J Clin Endocrinol Metab . 2002; 87:4054-4058.


Cook DM. AACE Acromegaly Guidelines Taskforce. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of acromegaly. Endoc Pract . 2004;10:213-225.


Glustina A, Barkan A, Casanueva FF, et al. Criteria for cure of acromegaly: a consensus statement. J Clin Endocrinol Metab . 2000;85:526-529.


Katznelson L, Atkinson JL, Cook DM, Ezzat SZ, Hamrahian AH, Miller KK. American association of clinical endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of acromegaly - 2011 update: executive summary. Endocr Pract . 2011;17(4):636-646.


Melmed S. Medical progress: acromegaly. N Engl J Med . 2006;355:2558-2573.


Paisley AN, Trainer PJ. Medical treatment in acromegaly. Curr Opin Pharmacol . 2003;3:672-677.


Sherlock M, Woods C, Sheppard MC. Medical therapy in acromegaly. Nat Rev Endocrinol . 2011;7(5):291-300.


Trainer PJ, Drake WM, Katzneison L, et al. Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomant. N Engl J Med . 2000; 342:1171-1177.

 

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