Abstract
Akromegali
aşırı büyüme hormonu (BH) salınımı
sonucu ortaya çıkan klinik sendromdur. Akromegalinin en sık nedeni ön hipofizde
BH salgılayan adenomdur. Akromegali başlangıcı sinsi ve genellikle yavaş
seyirlidir. Hemen hemen tüm hastalarda akral kemik ve yumuşak dokularda aşırı
büyüme mevcuttur. Karakteristik bulgular alt çene çıkıklığı, el ve ayak büyümesidir.
Akromegali hastalarında kardiyovasküler hastalık, kolon kanseri, tiroid kanseri
ve diğer tümörlerde risk artışı görülmektedir. Ölüm genellikle kardiyovasküler
hastalıklar nedeniyle olmaktadır. Akromegalinin temel tedavisi transsfenoidal
cerrahidir. Cerrahi sonrası kür sağlanmazsa uzun etkili somatostatin
analogları, kabergolin, pegvisomant gibi medikal tedaviler kullanılır. Medikal
tedaviye rağmen BH/IGF-1 veya adenom boyutunda artış olursa reoperasyon veya radyoterapi
kullanılabilir.
Keywords
References
- 1. Melmed S. Medical progress: Acromegaly. N Engl J Med 2006; 355:2558.2. Ribeiro-Oliveira A jr, Barkan A. The changing face of acromegaly-advances in diagnosis and treatment. Nat Rev Endocrinol 2012; 8:605.3. Melmed S. Acromegaly pathogenesis and treatment. J Clin Invest 2009; 119:3189.4. David G. Gardner, Dolores Shoback. Greenspan's Basic and Clinical Endocrinology. Tenth Edition. McGraw-Hill Education; 2017.5. Yashpal Gogate , Anil Bhansali. Clinical rounds in endocrinology: Volume I – adult endocrinology. Springer, India. 1st ed. 2016.6. Katznelson L, Laws ER Jr, Melmed S, et al. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014; 99:3933.7. Shlomo Melmed, Laurence Katznelson. Acromegaly. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on Jan 18, 2018.)8. Biermasz NR. New medical therapies on the horizon: oral octreotide. Pituitary. 2017 Feb;20(1):149-153.9. Maffezzoni F, Formenti AM, Mazziotti G, Frara S, Giustina A. Current and future medical treatments for patients with acromegaly. Expert Opin Pharmacother. 2016 Aug;17(12):1631-42.10. Grynberg M, Salenave S, Young J, Chanson P. Female gonadal function before and after treatment of acromegaly. J Clin Endocrinol Metab. 2010;95(10):4518.
Abstract
Acromegaly
is the clinical syndrome that results from excessive secretion of growth
hormone (GH). The most common cause of acromegaly is a GH secreting adenoma of
the anterior pituitary. The onset of acromegaly is insidious, and its
progression is usually very slow. Nearly all patients with acromegaly have
acral osseous and soft tissue overgrowth. The characteristic findings are an
enlarged jaw and enlarged, swollen hands and feet. Patients with acromegaly
appear to be at increased risk for cadiovascular disase, colon cancer, thyroid
cancer and other tumors. Death is generally caused by cardiovascular diseases. Transsphenoidal
surgery is the main therapy for patients with an acromegaly. After surgical
failure long-acting somatostatin analog, cabergolin or pegvisomant are
indicated. If adenoma size increases or GH/IGF-1
hypersecretion persists despite medical therapy, we suggest radiation therapy
(RT) or repeat surgery.
Keywords
References
- 1. Melmed S. Medical progress: Acromegaly. N Engl J Med 2006; 355:2558.2. Ribeiro-Oliveira A jr, Barkan A. The changing face of acromegaly-advances in diagnosis and treatment. Nat Rev Endocrinol 2012; 8:605.3. Melmed S. Acromegaly pathogenesis and treatment. J Clin Invest 2009; 119:3189.4. David G. Gardner, Dolores Shoback. Greenspan's Basic and Clinical Endocrinology. Tenth Edition. McGraw-Hill Education; 2017.5. Yashpal Gogate , Anil Bhansali. Clinical rounds in endocrinology: Volume I – adult endocrinology. Springer, India. 1st ed. 2016.6. Katznelson L, Laws ER Jr, Melmed S, et al. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014; 99:3933.7. Shlomo Melmed, Laurence Katznelson. Acromegaly. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on Jan 18, 2018.)8. Biermasz NR. New medical therapies on the horizon: oral octreotide. Pituitary. 2017 Feb;20(1):149-153.9. Maffezzoni F, Formenti AM, Mazziotti G, Frara S, Giustina A. Current and future medical treatments for patients with acromegaly. Expert Opin Pharmacother. 2016 Aug;17(12):1631-42.10. Grynberg M, Salenave S, Young J, Chanson P. Female gonadal function before and after treatment of acromegaly. J Clin Endocrinol Metab. 2010;95(10):4518.
Details
| Primary Language | Turkish |
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| Subjects | Health Care Administration |
| Journal Section | Review |
| Authors | |
| Publication Date | April 1, 2019 |
| Published in Issue | Year 2019 Volume: 2 Issue: 2 |
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