Diagnosis and management of acromegaly: the patient’s perspective

Kreitschmann-Andermahr, Ilonka; Siegel, Sonja; Kleist, Bernadette; Kohlmann, Johannes; Starz, Daniel; Buslei, Rolf; Kołtowska-Häggström, Maria; Strasburger, Christian J.; Buchfelder, Michael

doi:10.1007/s11102-015-0702-1

Cited by 47 publications

(34 citation statements)

References 32 publications

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“… 33 Nevertheless, patients often consult other specialists and dentists, besides primary care physicians, before obtaining the correct diagnosis, and are then treated according to the presenting symptoms, instead of being treated for acromegaly. 16 …”

Section: Diagnosis Of Acromegalymentioning

confidence: 99%

Acromegaly: a challenging condition to diagnose

AlDallal

2018

IJGM

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Acromegaly is an uncommon, chronic disease, characterized by hypersecretion of a pituitary growth hormone by somatotroph adenomas, along with increased levels of insulin-like growth factor-1. Although acromegaly presents a wide array of clinical manifestations, the salient symptoms include acral and soft tissue enlargement, joint pain, heart and respiratory failure, diabetes mellitus, and hypertension, leading to increased morbidity and mortality. Hence, early diagnosis of the disease is critical to enhance life expectancy and quality of life. New approaches are being developed for diagnosis and surveillance (both screening and follow-up), including sensitive biochemical assays and the use of MRI to visualize extremely small tumors, and are helpful in the early diagnosis of acromegaly, subsequent treatment, and disease control. This mini-review summarizes the most common and effective tools used in the diagnosis of acromegaly.

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Section: Diagnosis Of Acromegalymentioning

confidence: 99%

Acromegaly: a challenging condition to diagnose

AlDallal

2018

IJGM

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“…We did not try to assess the delay in the diagnosis of acromegaly in the present study. However, KreitschmannAndermahr and coworkers reported that the diagnostic process of acromegaly takes significantly longer in females compared with males (Kreitschmann-Andermahr et al 2016). According to a survey among 165 patients with acromegaly, disease duration from the estimated onset of symptoms until last surgery was 5.5 years, with no gender differences (Kreitschmann-Andermahr et al 2016).…”

Section: :6mentioning

confidence: 99%

“…However, KreitschmannAndermahr and coworkers reported that the diagnostic process of acromegaly takes significantly longer in females compared with males (Kreitschmann-Andermahr et al 2016). According to a survey among 165 patients with acromegaly, disease duration from the estimated onset of symptoms until last surgery was 5.5 years, with no gender differences (Kreitschmann-Andermahr et al 2016). Our study indicates that there is a significantly increased, 1.6-fold mortality in our nationwide cohort of patients with acromegaly compared with age-and gender-matched controls, and an increased SMR of 1.9 after 20 years of follow-up.…”

Section: :6mentioning

confidence: 99%

Mortality in acromegaly: a 20-year follow-up study

Ritvonen¹,

Löyttyniemi²,

Jaatinen³

et al. 2016

Endocrine-Related Cancer

143

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Objective: It is unclear whether mortality still is increased in acromegaly and whether there are gender-related differences. We dynamically assessed outcome during long-term follow-up in our nationwide cohort. Patients and methods: We studied standardized mortality ratios (SMRs) relative to the general population and causes of death in acromegaly (n = 333) compared with age-and gender-matched controls (n = 4995). Results: During 20 (0-33) years follow-up, 113 (34%) patients (n = 333, 52% women) and 1334 (27%) controls (n = 4995) died (P = 0.004). SMR (1.9, 95% CI: 1.53-2.34, P < 0.001) and all-cause mortality (OR 1.6, 95% CI: 1.2-2.2, P < 0.001) were increased in acromegaly. Overall distribution of causes of death (P < 0.001) differed between patients and controls but not cardiovascular (34% vs 33%) or cancer deaths (27% vs 27%). In acromegaly, but not in controls, causes of deaths shifted from 44% cardiovascular and 28% cancer deaths during the first decade, to 23% cardiovascular and 35% cancer deaths during the next two decades. In acromegaly, cancer deaths were mostly attributed to pancreatic adenocarcinoma (n = 5), breast (n = 4), lung (n = 3) and colon (n = 3) carcinoma. In acromegaly, men were younger than women at diagnosis (median 44.5 vs 50 years, P < 0.001) and death (67 vs 76 years, P = 0.0015). Compared with controls, women (36% vs 25%, P < 0.01), but not men (31% vs 28%, P = 0.44), had increased mortality. Conclusions: In acromegaly, men are younger at diagnosis and death than women. Compared with controls, mortality is increased during 20 years of follow-up, especially in women. Causes of deaths shift from predominantly cardiovascular to cancer deaths.

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“…A somatotrope pituitary adenoma can also cause local symptoms with hypopituitarism and visual field defects. The disease has an insidious onset and therefore, the delay to diagnosis is often substantial, 3-7 years from onset of symptoms (5,13,14,15).…”

Section: Introductionmentioning

confidence: 99%