Management of patients with Acromegaly   

Management of patients with Acromegaly   

H. Delshad M.D

Endocrinologist

Research  Institute for Endocrine Sciences

Shahid  Beheshti University of Medical Sciences

   Somatropin or Growth Hormone:

● GH is synthesized in somatotrope cells which make up about 50% of ant. Pituitary cells.

●The pulsatile secretion of GH is regulated by two hypothalamic regulatory hormones, GHRH and somatostatin.

      GH  Target  Tissues:

GH stimulates the hepatic production of IGF-1 that actually stimulates growth.

  Acromegaly:

•Persistent hyper-secretion of GH

• Prevalence : 60 – 120 individuals / million

• Condition is underrecognized and many patients may never receive medical attention.

• The average interval from the onset of symptoms until diagnosis is about 12 years.

   Acromegaly: Causes

• Pituitary somatotroph adenoma :

        The most common  , 75% macroadenoma

• GH-producing tumors are frequently mixed tumor

• Pituitary somatotroph carcinoma

• Hypothalamic  GHRH releasing tumors

• Non-endocrine GHRH secreting tumors

• Non-endocrine GH  secreting tumors

• Excess growth factor activity (Acromegaloidism)