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Endocr Rev. 2019 Feb 1;40(1):268-332. doi: 10.1210/er.2018-00115.

Systemic Complications of Acromegaly and the Impact of the Current Treatment Landscape: An Update.

Author information

1
Neuroendocrinology Research Center/Endocrine Section and Medical School, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
2
Neuroendocrine Section, Instituto Estadual do Cérebro Paulo Niemeyer, Secretaria Estadual de Saúde do Rio de Janeiro, Rio de Janeiro, Brazil.
3
Neuropathology and Molecular Genetics Laboratory, Instituto Estadual do Cérebro Paulo Niemeyer, Rio de Janeiro, Brazil.
4
Endocrine Unit, Hospital Federal de Bonsucesso, Rio de Janeiro, Brazil.
5
Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
6
Department of Endocrinology, Diabetes and Metabolism, Oregon Health and Science University, Portland, Oregon.
7
Department of Neurological Surgery, Oregon Health and Science University, Portland, Oregon.
8
Northwest Pituitary Center, Oregon Health and Science University, Portland, Oregon.

Abstract

Acromegaly is a chronic systemic disease with many complications and is associated with increased mortality when not adequately treated. Substantial advances in acromegaly treatment, as well as in the treatment of many of its complications, mainly diabetes mellitus, heart failure, and arterial hypertension, were achieved in the last decades. These developments allowed change in both prevalence and severity of some acromegaly complications and furthermore resulted in a reduction of mortality. Currently, mortality seems to be similar to the general population in adequately treated patients with acromegaly. In this review, we update the knowledge in complications of acromegaly and detail the effects of different acromegaly treatment options on these complications. Incidence of mortality, its correlation with GH (cumulative exposure vs last value), and IGF-I levels and the shift in the main cause of mortality in patients with acromegaly are also addressed.

PMID:
30184064
DOI:
10.1210/er.2018-00115
[Indexed for MEDLINE]

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