acromegaly Flashcards
what is acromegaly?
A rare condition where the body produces too much growth hormones causing body tissue and bones to grow more quickly.
what age is acromegaly normally diagnosed?
30-50
what is acromegaly called if it develops before the end of puberty?
-gigantism
what usually causes acromegaly?
-a non cancerous tumour in the pituitary gland called an adenoma
what are a normal adults GH levels?
<0.5mg/L
what tests can be done if a patient has suspected acromegaly?
- GH level test
- IGF-1 levels (almost always raised in acromegaly)
- Glucose tolerence test (25% of acromegaly patients have a positive diabetic glucose test)
- MRI
- Visual field exam
- Pituitary function (will usually show partial or complete anterior hypopituitarism)
- Prolactin (30% of patients show hyperprolactaemia)
what is first line treatment for acromegaly?
transsphenoidal surgery
what treatment is usually given to patients with acromegaly after surgery?
- Pituitary radiotherapy
- Medication
what medication can patients be on for acromegaly?
- Monthly injections of octreotide, lanreotide or pasireotide (somatostatin receptor agonists)
- bromocriptine or cabergoline trablets (dopamine agonists)
- daily pegvisomant (GH receptor antagonists)
what is an example of a somatostatin receptor agonist?
- octreotide
- lanreotide
- pasireotide
what is an example of dopamine agonists?
- bromocriptine
- cabergoline
what is an example of a GH receptor antagonist?
- pegvisomant injection
what side effects do somatostatin receptor agonists have? (octreotide, lanreotide, and pasireotide)
-can cause gallstones
what effect do somatostatin agonists have on patients with acromegaly?
-reduce GH and IGF-1 levels and can sometimes shrink the tumour
what effect do dopamine agonists (bromocriptine and cabergoline) have on acromegaly patients?
-shrink the tumour and also work on prolactin-secreting tumours however only work in a small number of patients
