Proceedings of the workshop, "Practical approaches to the diagnosis and treatment of acromegaly".
Practical approaches to the management of acromegaly are discussed. The roles of surgery, radiotherapy, and medical treatment with oral dopamine agonists such as bromocriptine or the long-acting somatostatin analogue octreotide given subcutaneously are reviewed. Most cases need surgery, but cure is rare in patients with macroadenomas, although common with microadenomas. Radiotherapy should be considered in surgical failures, but takes several years to be effective. Medical treatment with octreotide is effective in the majority, for whom it represents a major advance, but it needs to be administered subcutaneously and the development of gallstones and gastritis in long-term treatment are problems. Bromocriptine is usually less effective, but occasionally still plays a role in the therapeutic program. Combinations of the different modalities are usually required in the management of acromegalic patients.
Liuzzi
A
A
Department of Endocrinology, St Bartholomew's Hospital, London, UK.
Sobrinho
L G
LG
Besser
G M
GM
D000172:Acromegaly / Q000175:diagnosis* / Q000188:drug therapy*; D000236:Adenoma / Q000175:diagnosis / Q000188:drug therapy; D001971:Bromocriptine / Q000627:therapeutic use; D002769:Cholelithiasis / Q000139:chemically induced; D004298:Dopamine / Q000627:therapeutic use; D006801:Humans; D015282:Octreotide / Q000009:adverse effects / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000188:drug therapy
D001971:Bromocriptine; D015282:Octreotide; D004298:Dopamine