Acromegaly natural history, complications and prognosis: Difference between revisions

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Latest revision as of 12:39, 16 August 2017

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]

Overview

If left untreated, 30% of patients with acromegaly may progress to develop cardiovascular manifestations, pulmonary dysfunction, and cerebral complications. Common complications of acromegaly include hypertension, arrhythmia, heart failure, sleep apnea, dyspnea, carpal tunnel syndrome and spinal cord compression. Prognosis of acromegaly is generally good with transsphenoidal surgery and the postoperative treatment.

Natural History, Complications, and Prognosis

Natural History

If left untreated, 30% of patients with acromegaly may progress to develop cardiovascular manifestations, pulmonary dysfunction, and cerebral complications. These comorbidities will increase the mortality rate.^[1]

Complications

Common complications of acromegaly include:
- Cardivascualr complications:^[2]
  - Cardiovascular disease
  - Hypertension
  - Arrhythmias
  - Heart failure
  - Coronary arteriosclerosis
- Respiratory complications:
  - Sleep apnea
  - Dyspnea and stridor
- Neuromuscular complications:
  - Arthritis
  - Carpal tunnel syndrome
  - Spinal cord compression
  - Vision abnormalities
- Abdominal complications:
  - Colonic polyps
  - Uterine fibroids in females

Prognosis

Prognosis of acromegaly is generally good with transsphenoidal surgery and the postoperative treatment.
Early diagnosis and treatment of acromegaly are associated with better prognosis.^[3]
The acral features of the acromegaly in the face, hands, and feet usually return to normal after the surgery.

References

↑ Melmed S (2009). "Acromegaly pathogenesis and treatment". J Clin Invest. 119 (11): 3189–202. doi:10.1172/JCI39375. PMC 2769196. PMID 19884662.
↑ Berg C, Petersenn S, Lahner H, Herrmann BL, Buchfelder M, Droste M; et al. (2010). "Cardiovascular risk factors in patients with uncontrolled and long-term acromegaly: comparison with matched data from the general population and the effect of disease control". J Clin Endocrinol Metab. 95 (8): 3648–56. doi:10.1210/jc.2009-2570. PMID 20463098.
↑ Kršek M (2015). "[Acromegaly: current view]". Vnitr Lek. 61 (10): 900–4. PMID 26486485.

Template:WikiDoc Sources

[pmid19884662-1] Melmed S (2009). "Acromegaly pathogenesis and treatment". J Clin Invest. 119 (11): 3189–202. doi:10.1172/JCI39375. PMC 2769196. PMID 19884662.

[pmid20463098-2] Berg C, Petersenn S, Lahner H, Herrmann BL, Buchfelder M, Droste M; et al. (2010). "Cardiovascular risk factors in patients with uncontrolled and long-term acromegaly: comparison with matched data from the general population and the effect of disease control". J Clin Endocrinol Metab. 95 (8): 3648–56. doi:10.1210/jc.2009-2570. PMID 20463098.

[pmid26486485-3] Kršek M (2015). "[Acromegaly: current view]". Vnitr Lek. 61 (10): 900–4. PMID 26486485.

[1]

[2]

[3]

@@ Line 1: / Line 1: @@
 __NOTOC__
 {{Acromegaly}}
-{{CMG}}; {{AE}}
+{{CMG}}; {{AE}} {{AEL}}
 ==Overview==
-*If left untreated, [#]% of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
+If left untreated, 30% of patients with acromegaly may progress to develop [[cardiovascular]] manifestations, pulmonary dysfunction, and cerebral complications. Common complications of acromegaly include hypertension, [[arrhythmia]], [[heart failure]], [[sleep apnea]], [[dyspnea]], [[carpal tunnel syndrome]] and [[spinal cord compression]]. Prognosis of acromegaly is generally good with transsphenoidal surgery and the postoperative treatment.
-*Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
-*Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
 ==Natural History, Complications, and Prognosis==
 ===Natural History===
-*If left untreated, 30% of patients with acromegaly may progress to develop cardiovascular manifestations, pulmonary dysfunction and cerebral complications. These comorbidities will increase the mortality rate.<ref name="pmid19884662">{{cite journal| author=Melmed S| title=Acromegaly pathogenesis and treatment. | journal=J Clin Invest | year= 2009 | volume= 119 | issue= 11 | pages= 3189-202 | pmid=19884662 | doi=10.1172/JCI39375 | pmc=2769196 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19884662  }} </ref>
+*If left untreated, 30% of patients with acromegaly may progress to develop cardiovascular manifestations, pulmonary dysfunction, and cerebral complications. These comorbidities will increase the mortality rate.<ref name="pmid19884662">{{cite journal| author=Melmed S| title=Acromegaly pathogenesis and treatment. | journal=J Clin Invest | year= 2009 | volume= 119 | issue= 11 | pages= 3189-202 | pmid=19884662 | doi=10.1172/JCI39375 | pmc=2769196 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19884662  }} </ref>
 ===Complications===
-*Common complications of [disease name] include:
+*Common complications of acromegaly include:
-**[complication 1]
+**Cardivascualr complications:<ref name="pmid20463098">{{cite journal| author=Berg C, Petersenn S, Lahner H, Herrmann BL, Buchfelder M, Droste M et al.| title=Cardiovascular risk factors in patients with uncontrolled and long-term acromegaly: comparison with matched data from the general population and the effect of disease control. | journal=J Clin Endocrinol Metab | year= 2010 | volume= 95 | issue= 8 | pages= 3648-56 | pmid=20463098 | doi=10.1210/jc.2009-2570 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20463098  }} </ref>
-**[complication 2]
+*** [[Cardiovascular disease]]
-**[complication 3]
+*** [[Hypertension]]
+*** [[Arrhythmias]]
+*** [[Heart failure]]
+*** Coronary arteriosclerosis
+**Respiratory complications:
+***Sleep apnea
+***Dyspnea and stridor
+**Neuromuscular complications:
+***[[Arthritis]]
+*** [[Carpal tunnel syndrome]]
+*** [[Spinal cord compression]]
+*** Vision abnormalities
+**Abdominal complications:
+*** [[Colonic polyps]]
+*** [[Uterine fibroids]] in females
 ===Prognosis===
-*Prognosis is generally excellent/good/poor, and the 1/5/10-year mortality/survival rate of patients with [disease name] is approximately [#]%.
+*Prognosis of acromegaly is generally good with transsphenoidal surgery and the postoperative treatment.
-*Depending on the extent of the [tumor/disease progression/etc.] at the time of diagnosis, the prognosis may vary. However, the prognosis is generally regarded as poor/good/excellent.
+*Early diagnosis and treatment of acromegaly are associated with better prognosis.<ref name="pmid26486485">{{cite journal| author=Kršek M| title=[Acromegaly: current view]. | journal=Vnitr Lek | year= 2015 | volume= 61 | issue= 10 | pages= 900-4 | pmid=26486485 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26486485  }} </ref>
-*The presence of [characteristic of disease] is associated with a particularly [good/poor] prognosis among patients with [disease/malignancy].
+*The acral features of the acromegaly in the [[face]], [[hands]], and [[feet]] usually return to normal after the surgery.
-*[Subtype of disease/malignancy] is associated with the most favorable prognosis.
-*The prognosis varies with the [characteristic] of tumor; [subtype of disease/malignancy] have the most favorable prognosis.
-==Complications==
-* [[Arthritis]]
-* [[Cardiovascular disease]]
-* [[Carpal tunnel syndrome]]
-* [[Colonic polyps]]
-* [[Glucose intolerance]] or [[diabetes]]
-* [[High blood pressure]]
-* [[Hypopituitarism]]
-* [[Sleep apnea]]
-* [[Spinal cord compression]]
-* [[Uterine fibroids]]
-* Vision abnormalities
-==Prognosis==
-Pituitary surgery is successful in most patients, depending on the size of the tumor and the experience of the surgeon. Without treatment the symptoms will get worse, and the risk of cardiovascular disease increases.
 ==References==