The Jewish Hospital of St. Louis therapeutic grand rounds no. 9. Diagnosis and therapy of acromegaly.
Acromegaly, the clinical expression of chronic hypersecretion of growth hormone, develops insidiously and is too often not recognized until the disease is advanced. However, a useful screening procedure, the measurement of serum growth hormone after an oral glucose load, is available. Though evidence suggesting that acromegaly may be a disorder of defective hypothalamic regulation of pituitary growth hormone secretion has accumulated, the pathogenesis of the diease is not sufficiently understood to permit consistently effective medical therapy. Current therapy, therefore, is directed toward destruction of growth hormone producing pituitary tissue. Patients with major suprasellar extension and chiasmal compression usually require transfrontal surgery. Patients without major suprasellar extension can be treated with external irradiation or with transsphenoidal surgery. It is our current practice to limit the former to young patients withe relatively modest elevation of the serum growth hormone concentration.
D000172:Acromegaly / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D000328:Adult; D003452:Cryosurgery; D004967:Estrogens / Q000627:therapeutic use; D013006:Growth Hormone / Q000378:metabolism / Q000502:physiology; D006801:Humans; D007016:Hypophysectomy; D008297:Male; D008525:Medroxyprogesterone / Q000627:therapeutic use; D010902:Pituitary Gland / Q000378:metabolism; D010910:Pituitary Irradiation
D004967:Estrogens; D013006:Growth Hormone; D008525:Medroxyprogesterone