Acromegaly Follow-up

Author: Hasnain M Khandwala, MD, FRCPC; Chief Editor: George T Griffing, MD more...

Updated: Nov 15, 2011

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Inpatient & Outpatient Medications
Prognosis
Patient Education
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Inpatient & Outpatient Medications

See Medication.

Prognosis

Remission depends on the initial size of the tumor, the GH level, and the skill of the neurosurgeon. Remission rates of 80-85% and 50-65% can be expected for microadenomas and macroadenomas, respectively. The postoperative GH concentration may predict remission rates. According to the results of one study, a postoperative GH concentration of less than 3 ng/dL was associated with a 90% remission rate, which declined to 5% in patients with a postoperative GH concentration greater than 5 ng/dL.

Patient Education

For excellent patient education resources, visit eMedicine's Acromegaly Center. Also, see eMedicine's patient education articles Acromegaly, Acromegaly FAQs, and Understanding Acromegaly Medications.

Contributor Information and Disclosures

Author

Hasnain M Khandwala, MD, FRCPC Endocrinologist, LMC Endocrinology Centers, Canada

Hasnain M Khandwala, MD, FRCPC is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Physicians, American Diabetes Association, Canadian Medical Association, and Endocrine Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Barry J Goldstein, MD, PhD Director, Division of Endocrinology, Diabetes and Metabolic Diseases, Professor, Department of Internal Medicine, Thomas Jefferson University

Barry J Goldstein, MD, PhD is a member of the following medical societies: Alpha Omega Alpha, American College of Clinical Endocrinologists, American College of Physicians-American Society of Internal Medicine, American Diabetes Association, and Endocrine Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Arthur B Chausmer, MD, PhD, FACP, FACE, FACN, CNS Professor of Medicine (Endocrinology, Adj), Johns Hopkins School of Medicine; Affiliate Research Professor, Bioinformatics and Computational Biology Program, School of Computational Sciences, George Mason University; Principal, C/A Informatics, LLC

Arthur B Chausmer, MD, PhD, FACP, FACE, FACN, CNS is a member of the following medical societies: American Association of Clinical Endocrinologists, American College of Endocrinology, American College of Nutrition, American College of Physicians, American College of Physicians-American Society of Internal Medicine, American Medical Informatics Association, American Society for Bone and Mineral Research, Endocrine Society, and International Society for Clinical Densitometry

Disclosure: Nothing to disclose.

Mark Cooper, MBBS, PhD, FRACP Head, Diabetes & Metabolism Division, Baker Heart Research Institute, Professor of Medicine, Monash University

Disclosure: Nothing to disclose.

Chief Editor

George T Griffing, MD Professor of Medicine, St Louis University School of Medicine

George T Griffing, MD is a member of the following medical societies: American Association for the Advancement of Science, American College of Medical Practice Executives, American College of Physician Executives, American College of Physicians, American Diabetes Association, American Federation for Medical Research, American Heart Association, Central Society for Clinical Research, Endocrine Society, International Society for Clinical Densitometry, and Southern Society for Clinical Investigation

Disclosure: Nothing to disclose.

References

Giustina A, Chanson P, Bronstein MD, et al. A consensus on criteria for cure of acromegaly. J Clin Endocrinol Metab. Jul 2010;95(7):3141-8. [Medline].
Chahal HS, Stals K, Unterländer M, Balding DJ, et al. AIP mutation in pituitary adenomas in the 18th century and today. N Engl J Med. Jan 6 2011;364(1):43-50. [Medline].
Berg C, Petersenn S, Lahner H, Herrmann BL, Buchfelder M, Droste M, et al. Cardiovascular risk factors in patients with uncontrolled and long-term acromegaly: comparison with matched data from the general population and the effect of disease control. J Clin Endocrinol Metab. Aug 2010;95(8):3648-56. [Medline].
Bates AS, Van't Hoff W, Jones JM, et al. An audit of outcome of treatment in acromegaly. Q J Med. May 1993;86(5):293-9. [Medline].
[Guideline] Katznelson L, Atkinson JL, Cook DM, et al. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Acromegaly--2011 update: executive summary. Endocr Pract. Jul-Aug 2011;17(4):636-46. [Medline].
Sandret L, Maison P, Chanson P. Place of Cabergoline in Acromegaly: A Meta-Analysis. J Clin Endocrinol Metab. Feb 16 2011;[Medline].
Asa SL. The pathology of pituitary tumors. Endocrinol Metab Clin North Am. 28(1):13-43, v-vi. [Medline].
Ezzat S. Acromegaly. Endocrinol Metab Clin North Am. Dec 1997;26(4):703-23. [Medline].
Feenstra J, de Herder WW, ten Have SM, et al. Combined therapy with somatostatin analogues and weekly pegvisomant in active acromegaly. Lancet. May 7-13 2005;365(9471):1644-6. [Medline].
Freda PU. Current concepts in the biochemical assessment of the patient with acromegaly. Growth Horm IGF Res. Aug 2003;13(4):171-84. [Medline].
Freda PU, Wardlaw SL, Post KD. Long-term endocrinological follow-up evaluation in 115 patients who underwent transsphenoidal surgery for acromegaly. J Neurosurg. Sep 1998;89(3):353-8. [Medline].
Gagel RF, McCutcheon IE. Images in clinical medicine. Pituitary gigantism. N Engl J Med. Feb 18 1999;340(7):524. [Medline].
McCutcheon IE. Management of individual tumor syndromes. Pituitary neoplasia. Endocrinol Metab Clin North Am. Mar 1994;23(1):37-51. [Medline].
Melmed S, Ho K, Klibanski A, et al. Clinical review 75: Recent advances in pathogenesis, diagnosis, and management of acromegaly. J Clin Endocrinol Metab. Dec 1995;80(12):3395-402. [Medline].
Melmed S, Jackson I, Kleinberg D, Klibanski A. Current treatment guidelines for acromegaly. J Clin Endocrinol Metab. Aug 1998;83(8):2646-52. [Medline].
Newman CB. Medical therapy for acromegaly. Endocrinol Metab Clin North Am. Mar 1999;28(1):171-90. [Medline].
Newman CB, Melmed S, George A, et al. Octreotide as primary therapy for acromegaly. J Clin Endocrinol Metab. Sep 1998;83(9):3034-40. [Medline].
Paisley AN, Trainer PJ. Medical treatment in acromegaly. Curr Opin Pharmacol. Dec 2003;3(6):672-7. [Medline].
Rajasoorya C, Holdaway IM, Wrightson P, et al. Determinants of clinical outcome and survival in acromegaly. Clin Endocrinol (Oxf). Jul 1994;41(1):95-102. [Medline].
Spada A, Vallar L. G-protein oncogenes in acromegaly. Horm Res. 1992;38(1-2):90-3. [Medline].
Thorner M, Vance ML, Laws E. The anterior pituitary. In: Wilson JD, ed. Williams Textbook of Endocrinology. 9^th ed. Philadelphia, Pa: Saunders; 1998:249-340.
Trainer PJ, Drake WM, Katznelson L, et al. Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomant. N Engl J Med. Apr 20 2000;342(16):1171-7. [Medline].

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