title: Acromegaly.
abstract: Subcellular mechanisms support the notion of an intrinsic pituitary defect in acromegaly, with elevated growth hormone (GH) and insulin-like growth factor-1 (IGF-1) levels that affect the cardiovascular and respiratory system, as well as neoplastic cell proliferative activity. Surgery, even with external-beam irradiation adjuvant therapy, is only successful in less than 60% of patients, and there are side effects. Normalization of GH levels may improve survival rates. Octreotide has revolutionized patient management, normalizing GH and IGF-1 levels in up to 60%, ameliorating soft-tissue abnormalities and reducing tumor size in up to 50%, and attenuating GH levels in more than 90% of patients. Issues concerning the role of octreotide, as well as clarifying precise outcome measures, still need to be resolved.
authors.affiliation: Division of Endocrinology and Metabolism, Cedars-Sinai Research Institute, UCLA School of Medicine 90048-1865, USA.
authors.forename: S
authors.initials: S
authors.lastname: Melmed
mesh_terms: D000172:Acromegaly / Q000097:blood* / Q000209:etiology / Q000628:therapy*; D000236:Adenoma / Q000601:surgery; D013006:Growth Hormone / Q000097:blood* / Q000502:physiology; D006801:Humans; D015282:Octreotide / Q000627:therapeutic use; D010911:Pituitary Neoplasms / Q000601:surgery
chemical_list: D013006:Growth Hormone; D015282:Octreotide