Acromegaly natural history, complications and prognosis: Difference between revisions

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==Overview==
==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==
==Natural History, Complications, and Prognosis==
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==Complications==
===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>


* [[Arthritis]]
===Complications===
* [[Cardiovascular disease]]
*Common complications of acromegaly include:
* [[Carpal tunnel syndrome]]
**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>
* [[Colonic polyps]]
*** [[Cardiovascular disease]]
* [[Glucose intolerance]] or [[diabetes]]
*** [[Hypertension]]
* [[High blood pressure]]
*** [[Arrhythmias]]
* [[Hypopituitarism]]
*** [[Heart failure]]
* [[Sleep apnea]]
*** Coronary arteriosclerosis
* [[Spinal cord compression]]
**Respiratory complications:
* [[Uterine fibroids]]
***Sleep apnea
* Vision abnormalities
***Dyspnea and stridor
**Neuromuscular complications:
***[[Arthritis]]
*** [[Carpal tunnel syndrome]]
*** [[Spinal cord compression]]
*** Vision abnormalities
**Abdominal complications:
*** [[Colonic polyps]]
*** [[Uterine fibroids]] in females


==Prognosis==
===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.  
*Prognosis of acromegaly is generally good with transsphenoidal surgery and the postoperative treatment.
*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 acral features of the acromegaly in the [[face]], [[hands]], and [[feet]] usually return to normal after the surgery.


==References==
==References==
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Latest revision as of 12:39, 16 August 2017

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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

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

  1. ↑ Melmed S (2009). "Acromegaly pathogenesis and treatment". J Clin Invest. 119 (11): 3189–202. doi:10.1172/JCI39375. PMC 2769196. PMID 19884662.
  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.
  3. ↑ Kršek M (2015). "[Acromegaly: current view]". Vnitr Lek. 61 (10): 900–4. PMID 26486485.


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