title: Reevaluation of Acromegalic Patients in Long-Term Remission according to Newly Proposed Consensus Criteria for Control of Disease.
abstract: Acromegaly guidelines updated in 2010 revisited criteria of disease control: if applied, it is likely that a percentage of patients previously considered as cured might present postglucose GH nadir levels not adequately suppressed, with potential implications on management. This study explored GH secretion, as well as hormonal, clinical, neuroradiological, metabolic, and comorbid profile in a cohort of 40 acromegalic patients considered cured on the basis of the previous guidelines after a mean follow-up period of 17.2 years from remission, in order to assess the impact of the current criteria. At the last follow-up visit, in the presence of normal IGF-I concentrations, postglucose GH nadir was over 0.4 μg/L in 11 patients (Group A) and below 0.4 μg/L in 29 patients (Group B); moreover, Group A showed higher basal GH levels than Group B, whereas a significant decline of both GH and postglucose GH nadir levels during the follow-up was observed in Group B only. No differences in other evaluated parameters were found. These results seem to suggest that acromegalic patients considered cured on the basis of previous guidelines do not need a more intensive monitoring than patients who met the current criteria of disease control, supporting instead that the cut-off of 0.4 mcg/L might be too low for the currently used GH assay.
authors.affiliation: Endocrinology and Diabetology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Padiglione Granelli, Via F. Sforza 35, 20122 Milan, Italy.
authors.forename: Elisa
authors.identifier: 0000-0003-2046-6847
authors.initials: E
authors.lastname: Verrua
authors.affiliation: Endocrinology and Diabetology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Padiglione Granelli, Via F. Sforza 35, 20122 Milan, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Ferrante
authors.affiliation: Endocrinology and Diabetology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Padiglione Granelli, Via F. Sforza 35, 20122 Milan, Italy.
authors.forename: Marcello
authors.identifier: 0000-0001-7141-2369
authors.initials: M
authors.lastname: Filopanti
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Malchiodi
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Sala
authors.affiliation: Endocrinology and Diabetology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Padiglione Granelli, Via F. Sforza 35, 20122 Milan, Italy.
authors.forename: Claudia
authors.initials: C
authors.lastname: Giavoli
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy ; Unit of Endocrine Diseases and Diabetology, Ospedale San Giuseppe Multimedica, 20123 Milan, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Arosio
authors.affiliation: Endocrine Unit, IRCCS Humanitas Clinical Institute, 20089 Rozzano, Italy ; Department of Medicine Biotechnology and Translational Medicine, University of Milan, 20122 Milan, Italy.
authors.forename: Andrea Gerardo
authors.initials: AG
authors.lastname: Lania
authors.affiliation: Endocrine and Diabetes Unit, Department of Internal Medicine I, University Hospital of Würzburg, 97070 Würzburg, Germany.
authors.forename: Cristina Lucia
authors.initials: CL
authors.lastname: Ronchi
authors.affiliation: Endocrinology and Diabetology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Padiglione Granelli, Via F. Sforza 35, 20122 Milan, Italy ; Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mantovani
authors.affiliation: Endocrinology and Diabetology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Padiglione Granelli, Via F. Sforza 35, 20122 Milan, Italy ; Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Beck-Peccoz
authors.affiliation: Endocrinology and Diabetology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Padiglione Granelli, Via F. Sforza 35, 20122 Milan, Italy ; Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Spada