Anatomy & Pathophysiology of Acromegaly
Slow growing, densley granulated somatotroph tumors occur in up to ______ of acromegaly cases
What is 50%
Up to _____ of patients with acromegaly have arthropathy?
What is 70%
After symptom onset, it often take patients _______ to receive a diagnosis
What is years
These categories of therapies are used for the treatment of acromegaly
What is SRLs, Off-label dopamine receptor agonist, and GH receptor antagonist
This occurs when GH excess leads to increased linear growth before the end of puberty
What is gigantism
Increased GH secretion results in ____________ of IGF-1, resulting in excess growth of muscle and bone in patients with acromegaly.
What is hypersecretion
These three categories contribute to reduced QoL for patients with acromegaly
What is physical & functional burden, psychosocial challenges and health complications
Acromegaly affects both men and women, but there may be a slightly higher percentage affected in _____
What is women
THis is the preferred first line intervention for acromegaly.
What is surgery
This is the median age at diagnosis that has been consistently reported
What is 40-50 years
Acromegaly is almost always due to a ______ ______ that produces excess GH and stimulates hyspersecretion of IGF-1.
What is a pituitary adenoma
According to an observational, multicenter study of 195 patients receiving injectable SRLs this percent of acromegaly patients reported symptoms despite treatment.
What is 70%
What is NOT used to support a diagnosis of acromegaly?
What is genetic testing
This is considered third line therapy according to management guidelines for acromegaly.
What is radiation therapy
This is also known as Somatotropin
What is Growth Hormone
______ ________ are associated with anxiety and frustration, and logistical inconveinence
What is SRL injections
These two levels are measured to screen for acromegaly
What is GH and IGH-1
According to guidelines, biochemical control targets include IGF-1 ______ and random GH ______
What is less than or equal to 1x ULN and <1 ng/mL
This part of the pituitary is responsible for secreting GH into the bloodstream where it targets bone cells, muscle cells, nervous system cells, immjune cells and the liver
What is the anterior pituitary
According to an observational multicenter study of 195 patients receiving injctable SRLs, 52% of patients reported ______ ______ as they neared the end of their dosing interval
What is symptom worsening
Patients with uncontrolled acromegaly have higher _______ ______ than biochemically controlled patients.
What is mortality rates
According to retrospective studies, an IGF-1 level of ________ may confer a more adverse outcome.
What is >1.2x ULN