Generic placeholder image

Endocrine, Metabolic & Immune Disorders - Drug Targets


ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

Position Statement

Italian Association of Clinical Endocrinologists (AME) and Italian AACE Chapter Position Statement for Clinical Practice: Acromegaly - Part 1: Diagnostic and Clinical Issues

Author(s): Renato Cozzi*, Maria R. Ambrosio, Roberto Attanasio, Alessandro Bozzao, Laura De Marinis, Ernesto De Menis, Edoardo Guastamacchia, Andrea Lania, Giovanni Lasio, Francesco Logoluso, Pietro Maffei, Maurizio Poggi, Vincenzo Toscano, Michele Zini, Philippe Chanson and Laurence Katznelson

Volume 20, Issue 8, 2020

Page: [1133 - 1143] Pages: 11

DOI: 10.2174/1871530320666200127103320

open access plus


Acromegaly is a rare disease. Improvements in lifespan in these patients have recently been reported due to transsphenoidal surgery (TSS), advances in medical therapy, and strict criteria for defining disease remission. This document reports the opinions of a group of Italian experts who have gathered together their prolonged clinical experience in the diagnostic and therapeutic challenges of acromegaly patients. Both GH and IGF-I (only IGF-I in those treated with Pegvisomant) are needed in the diagnosis and follow-up. Comorbidities (cardio-cerebrovascular disease, sleep apnea, metabolic derangement, neoplasms, and bone/joint disease) should be specifically addressed. Any newly diagnosed patient should be referred to a multidisciplinary team experienced in the treatment of pituitary adenomas.

Keywords: Acromegaly, pituitary, comorbidities, discrepant, GH, IGF-I.

Next »
Graphical Abstract
Cozzi, R.; Baldelli, R.; Colao, A.; Lasio, G.; Zini, M.; Attanasio, R.; Chanson, P.; Giustina, A.; Ghigo, E.; Strasburger, C. Italian Association of Clinical Endocrinologists (AME). AME Position Statement on clinical management of acromegaly. J. Endocrinol. Invest., 2009, 32(Suppl. 6), 2-25. [no LoE
[PMID: 19923883]
Atkins, D.; Best, D.; Briss, P.A.; Eccles, M.; Falck-Ytter, Y.; Flottorp, S.; Guyatt, G.H.; Harbour, R.T.; Haugh, M.C.; Henry, D.; Hill, S.; Jaeschke, R.; Leng, G.; Liberati, A.; Magrini, N.; Mason, J.; Middleton, P.; Mrukowicz, J.; O’Connell, D.; Oxman, A.D.; Phillips, B.; Schünemann, H.J.; Edejer, T.; Varonen, H.; Vist, G.E.; Williams, J.W., Jr; Zaza, S. Grading quality of evidence and strength of recommendations. BMJ, 2004, 328(7454), 1490-1497. [no LoE
[] [PMID: 15205295]
Swiglo, B.A.; Murad, M.H.; Schünemann, H.J.; Kunz, R.; Vigersky, R.A.; Guyatt, G.H.; Montori, V.M. A case for clarity, consistency, and helpfulness: state-of-the-art clinical practice guidelines in endocrinology using the grading of recommendations, assessment, development, and evaluation system. J. Clin. Endocrinol. Metab., 2008, 93(3), 666-673. [no LoE
[] [PMID: 18171699]
Guyatt, G.H.; Oxman, A.D.; Vist, G.E.; Kunz, R.; Falck-Ytter, Y.; Alonso-Coello, P.; Schünemann, H.J. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ, 2008, 336(7650), 924-926. [no LoE
[] [PMID: 18436948]
Fernandez, A.; Karavitaki, N.; Wass, J.A. Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin. Endocrinol. (Oxf.), 2010, 72(3), 377-382. [LoE
Lavrentaki, A.; Paluzzi, A.; Wass, J.A.; Karavitaki, N. Epidemiology of acromegaly: review of population studies. Pituitary, 2017, 20(1), 4-9. [LoE ςςς□
[] [PMID: 27743174]
Holdaway, I.M.; Rajasoorya, C. Epidemiology of acromegaly. Pituitary, 1999, 2(1), 29-41. [no LoE
Petrossians, P.; Daly, A.F.; Natchev, E.; Maione, L.; Blijdorp, K.; Sahnoun-Fathallah, M.; Auriemma, R.; Diallo, A.M.; Hulting, A.L.; Ferone, D.; Hana, V., Jr; Filipponi, S.; Sievers, C.; Nogueira, C.; Fajardo-Montañana, C.; Carvalho, D.; Hana, V.; Stalla, G.K.; Jaffrain-Réa, M.L.; Delemer, B.; Colao, A.; Brue, T.; Neggers, S.J.C.M.M.; Zacharieva, S.; Chanson, P.; Beckers, A. Acromegaly at diagnosis in 3173 patients from the Liège Acromegaly Survey (LAS) database. Endocr. Relat. Cancer, 2017, 24(10), 505-518. [LoE ςςς□
[] [PMID: 28733467]
Wright, A.D.; Hill, D.M.; Lowy, C.; Fraser, T.R. Mortality in acromegaly. QJM-. Int. J. Med. (Dubai), 1970, 39(153), 1-16. [LoE
Dekkers, O.M.; Biermasz, N.R.; Pereira, A.M.; Romijn, J.A.; Vandenbroucke, J.P. Mortality in acromegaly: A metaanalysis. J. Clin. Endocrinol. Metab., 2008, 93(1), 61-67. [LoE ςςς□
Arosio, M.; Reimondo, G.; Malchiodi, E.; Berchialla, P.; Borraccino, A.; De Marinis, L.; Pivonello, R.; Grottoli, S.; Losa, M.; Cannavò, S.; Minuto, F.; Montini, M.; Bondanelli, M.; De Menis, E.; Martini, C.; Angeletti, G.; Velardo, A.; Peri, A.; Faustini-Fustini, M.; Tita, P.; Pigliaru, F.; Borretta, G.; Scaroni, C.; Bazzoni, N.; Bianchi, A.; Appetecchia, M.; Cavagnini, F.; Lombardi, G.; Ghigo, E.; Beck-Peccoz, P.; Colao, A.; Terzolo, M. Italian Study Group of Acromegaly. Predictors of morbidity and mortality in acromegaly: An Italian survey. Eur. J. Endocrinol., 2012, 167(2), 189-198. [LoE ςςς□
[] [PMID: 22596288]
Ritvonen, E.; Löyttyniemi, E.; Jaatinen, P.; Ebeling, T.; Moilanen, L.; Nuutila, P.; Kauppinen-Mäkelin, R.; Schalin-Jäntti, C. Mortality in acromegaly: A 20-year follow-up study. Endocr. Relat. Cancer, 2016, 23(6), 469-480. [LoE ςςς□
[] [PMID: 27185871]
Esposito, D.; Ragnarsson, O.; Granfeldt, D.; Marlow, T.; Johannsson, G.; Olsson, D.S. Decreasing mortality and changes in treatment patterns in patients with acromegaly from a nationwide study. Eur. J. Endocrinol., 2018, 178(5), 459-469. [LoE
[] [PMID: 29483205]
Varadhan, L.; Reulen, R.C.; Brown, M.; Clayton, R.N. The role of cumulative growth hormone exposure in determining mortality and morbidity in acromegaly: A single centre study. Pituitary, 2016, 19(3), 251-261. [LoE ς□□□
[] [PMID: 26724807]
Maione, L.; Brue, T.; Beckers, A.; Delemer, B.; Petrossians, P.; Borson-Chazot, F.; Chabre, O.; François, P.; Bertherat, J.; Cortet-Rudelli, C.; Chanson, P. Changes in the management and comorbidities of acromegaly over three decades: The French Acromegaly Registry. Eur. J. Endocrinol., 2017, 176(5), 645-655. [LoE
[] [PMID: 28246150]
Bolfi, F.; Neves, A.F.; Boguszewski, C.L.; Nunes-Nogueira, V.S. Mortality in acromegaly decreased in the last decade: A systematic review and meta-analysis. Eur. J. Endocrinol., 2018, 179(1), 59-71. [LoE ςςς□
[] [PMID: 29764907]
Katznelson, L.; Laws, E.R., Jr; Melmed, S.; Molitch, M.E.; Murad, M.H.; Utz, A.; Wass, J.A. Endocrine Society. Acromegaly: An endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab., 2014, 99(11), 3933-3951. [no LoE
[] [PMID: 25356808]
Ribeiro de Oliveira Longo Schweizer, J.; Ribeiro-Oliveira, A., Jr; Bidlingmaier, M. Growth hormone: isoforms, clinical aspects and assays interference. Clin. Diabetes Endocrinol., 2018, 4, 18. [no LoE
[] [PMID: 30181896]
Milani, D.; Carmichael, J.D.; Welkowitz, J.; Ferris, S.; Reitz, R.E.; Danoff, A.; Kleinberg, D.L. Variability and reliability of single serum IGF-I measurements: Impact on determining predictability of risk ratios in disease development. J. Clin. Endocrinol. Metab., 2004, 89(5), 2271-2274. [LoE ς□□□
[] [PMID: 15126552]
Junnila, R.K.; Strasburger, C.J.; Bidlingmaier, M. Pitfalls of insulin-like growth factor-I and growth hormone assays. Endocrinol. Metab. Clin. North Am., 2015, 44(1), 27-34. [no LoE
[] [PMID: 25732639]
Giustina, A.; Chanson, P.; Kleinberg, D.; Bronstein, M.D.; Clemmons, D.R.; Klibanski, A.; van der Lely, A.J.; Strasburger, C.J.; Lamberts, S.W.; Ho, K.K.; Casanueva, F.F.; Melmed, S. Expert consensus document: A consensus on the medical treatment of acromegaly. Nat. Rev. Endocrinol., 2014, 10(4), 243-248. [no LoE
[] [PMID: 24566817]
Freda, P.U.; Post, K.D.; Powell, J.S.; Wardlaw, S.L. Evaluation of disease status with sensitive measures of growth hormone secretion in 60 postoperative patients with acromegaly. J. Clin. Endocrinol. Metab., 1998, 83(11), 3808-3816. [LoE
[] [PMID: 9814451]
Schilbach, K.; Gar, C.; Lechner, A.; Nicolay, S.S.; Schwerdt, L.; Haenelt, M.; Dal, J.; Jørgensen, J.L.; Störmann, S.; Schopohl, J.; Bidlingmaier, M. Determinants of the growth hormone nadir during oral glucose tolerance test in adults. Eur. J. Endocrinol., 2019, 181(1), 55-67. [LoE ςςς□
[] [PMID: 31096183]
Feelders, R.A.; Bidlingmaier, M.; Strasburger, C.J.; Janssen, J.A.; Uitterlinden, P.; Hofland, L.J.; Lamberts, S.W.; van der Lely, A.J.; de Herder, W.W. Postoperative evaluation of patients with acromegaly: Clinical significance and timing of oral glucose tolerance testing and measurement of (free) insulin-like growth factor I, acid-labile subunit, and growth hormone-binding protein levels. J. Clin. Endocrinol. Metab., 2005, 90(12), 6480-6489. [LoE
[] [PMID: 16159936]
Katznelson, L.; Atkinson, J.L.; Cook, D.M.; Ezzat, S.Z.; Hamrahian, A.H. Miller, KK American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of acromegaly—2011 update. Endocr. Pract., 2011, (17)(Suppl. 4), 1-44. [no LoE
Reimondo, G.; Bondanelli, M.; Ambrosio, M.R.; Grimaldi, F.; Zaggia, B.; Zatelli, M.C.; Allasino, B.; Laino, F.; Aroasio, E.; Termine, A.; Conton, P.; Paoletta, A.; Demenis, E.; Uberti, E.D.; Terzolo, M. Growth hormone values after an oral glucose load do not add clinically useful information in patients with acromegaly on long-term somatostatin receptor ligand treatment. Endocrine, 2014, 45(1), 122-127. [LoE
[] [PMID: 23794116]
Schilbach, K.; Strasburger, C.J.; Bidlingmaier, M. Biochemical investigations in diagnosis and follow up of acromegaly. Pituitary, 2017, 20(1), 33-45. [no LoE
[] [PMID: 28168377]
Kanakis, G.A.; Chrisoulidou, A.; Bargiota, A.; Efstathiadou, Z.A.; Papanastasiou, L.; Theodoropoulou, A.; Tigas, S.K.; Vassiliadi, D.A.; Tsagarakis, S.; Alevizaki, M. The ongoing challenge of discrepant growth hormone and insulin-like growth factor I results in the evaluation of treated acromegalic patients: A systematic review and meta-analysis. Clin. Endocrinol. (Oxf.), 2016, 85(5), 681-688. [LoE
[] [PMID: 27292418]
Romano, A.; Coppola, V.; Lombardi, M.; Lavorato, L.; Di Stefano, D.; Caroli, E.; Rossi Espagnet, M.C.; Tavanti, F.; Minniti, G.; Trillò, G.; Bozzao, A. Predictive role of dynamic contrast enhanced T1-weighted MR sequences in pre-surgical evaluation of macroadenomas consistency. Pituitary, 2017, 20(2), 201-209. [LoE
[] [PMID: 27730456]
Dhandapani, S.; Singh, H.; Negm, H.M.; Cohen, S.; Anand, V.K.; Schwartz, T.H. Cavernous sinus invasion in pituitary adenomas: Systematic review and pooled data meta-analysis of radiologic criteria and comparison of endoscopic and microscopic surgery. World Neurosurg., 2016, 96(12), 36-46. [LoE ςςς□
[] [PMID: 27591098]
Potorac, I.; Petrossians, P.; Daly, A.F.; Alexopoulou, O.; Borot, S.; Sahnoun-Fathallah, M.; Castinetti, F.; Devuyst, F.; Jaffrain-Rea, M.L.; Briet, C.; Luca, F.; Lapoirie, M.; Zoicas, F.; Simoneau, I.; Diallo, A.M.; Muhammad, A.; Kelestimur, F.; Nazzari, E.; Centeno, R.G.; Webb, S.M.; Nunes, M.L.; Hana, V.; Pascal-Vigneron, V.; Ilovayskaya, I.; Nasybullina, F.; Achir, S.; Ferone, D.; Neggers, S.J.C.M.M.; Delemer, B.; Petit, J.M.; Schöfl, C.; Raverot, G.; Goichot, B.; Rodien, P.; Corvilain, B.; Brue, T.; Schillo, F.; Tshibanda, L.; Maiter, D.; Bonneville, J.F.; Beckers, A. T2-weighted MRI signal predicts hormone and tumor responses to somatostatin analogs in acromegaly. Endocr. Relat. Cancer, 2016, 23(11), 871-881. [LoE
[] [PMID: 27649724]
Shen, M.; Zhang, Q.; Liu, W.; Wang, M.; Zhu, J.; Ma, Z.; He, W.; Li, S.; Shou, X.; Li, Y.; Zhang, Z.; Ye, H.; He, M.; Lu, B.; Yao, Z.; Lu, Y.; Qiao, N.; Ye, Z.; Zhang, Y.; Yang, Y.; Zhao, Y.; Wang, Y. Predictive value of T2 relative signal intensity for response to somatostatin analogs in newly diagnosed acromegaly. Neuroradiology, 2016, 58(11), 1057-1065. [LoE
[] [PMID: 27516099]
Potorac, I.; Beckers, A.; Bonneville, J.F. T2-weighted MRI signal intensity as a predictor of hormonal and tumoral responses to somatostatin receptor ligands in acromegaly: A perspective. Pituitary, 2017, 20(1), 116-120. [no LoE
[] [PMID: 28197813]
Ghazi, A.A.; Amirbaigloo, A.; Dezfooli, A.A.; Saadat, N.; Ghazi, S.; Pourafkari, M.; Tirgari, F.; Dhall, D.; Bannykh, S.; Melmed, S.; Cooper, O. Ectopic acromegaly due to growth hormone releasing hormone. Endocrine, 2013, 43(2), 293-302. [LoE ς□□□
[] [PMID: 22983831]
Casarini, A.P.M.; Pinto, E.M.; Jallad, R.S.; Giorgi, R.R.; Giannella-Neto, D.; Bronstein, M.D. Dissociation between tumor shrinkage and hormonal response during somatostatin analog treatment in an acromegalic patient: Preferential expression of somatostatin receptor subtype 3. J. Endocrinol. Invest., 2006, 29(9), 826-830. [LoE ς□□□
[] [PMID: 17114915]
Resmini, E.; Dadati, P.; Ravetti, J-L.; Zona, G.; Spaziante, R.; Saveanu, A.; Jaquet, P.; Culler, M.D.; Bianchi, F.; Rebora, A.; Minuto, F.; Ferone, D. Rapid pituitary tumor shrinkage with dissociation between antiproliferative and antisecretory effects of a long-acting octreotide in an acromegalic patient. J. Clin. Endocrinol. Metab., 2007, 92(5), 1592-1599. [LoE ς□□□
[] [PMID: 17311860]
Gadelha, M.R.; Kasuki, L.; Korbonits, M. The genetic background of acromegaly. Pituitary, 2017, 20(1), 10-21. [no LoE
[] [PMID: 28161730]
Beckers, A.; Aaltonen, L.A.; Daly, A.F.; Karhu, A. Familial isolated pituitary adenomas (FIPA) and the pituitary adenoma predisposition due to mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene. Endocr. Rev., 2013, 34(2), 239-277. [no LoE
[] [PMID: 23371967]
Iacovazzo, D.; Caswell, R.; Bunce, B.; Jose, S.; Yuan, B.; Hernández-Ramírez, L.C.; Kapur, S.; Caimari, F.; Evanson, J.; Ferraù, F.; Dang, M.N.; Gabrovska, P.; Larkin, S.J.; Ansorge, O.; Rodd, C.; Vance, M.L.; Ramírez-Renteria, C.; Mercado, M.; Goldstone, A.P.; Buchfelder, M.; Burren, C.P.; Gurlek, A.; Dutta, P.; Choong, C.S.; Cheetham, T.; Trivellin, G.; Stratakis, C.A.; Lopes, M.B.; Grossman, A.B.; Trouillas, J.; Lupski, J.R.; Ellard, S.; Sampson, J.R.; Roncaroli, F.; Korbonits, M. Germline or somatic GPR101 duplication leads to X-linked acrogigantism: A clinico-pathological and genetic study. Acta Neuropathol. Commun., 2016, 4(1), 56. [LoE
[] [PMID: 27245663]
Saeger, W.; Lüdecke, D.K.; Buchfelder, M.; Fahlbusch, R.; Quabbe, H.J.; Petersenn, S. Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Registry. Eur. J. Endocrinol., 2007, 156(2), 203-216. [no LoE
[] [PMID: 17287410]
Thakker, R.V.; Newey, P.J.; Walls, G.V.; Bilezikian, J.; Dralle, H.; Ebeling, P.R.; Melmed, S.; Sakurai, A.; Tonelli, F.; Brandi, M.L. Endocrine Society. Clinical practice guidelines for multiple endocrine neoplasia type 1 (MEN1). J. Clin. Endocrinol. Metab., 2012, 97(9), 2990-3011. [no LoE
[] [PMID: 22723327]
de Laat, J.M.; Dekkers, O.M.; Pieterman, C.R.; Kluijfhout, W.P.; Hermus, A.R.; Pereira, A.M.; van der Horst-Schrivers, A.N.; Drent, M.L.; Bisschop, P.H.; Havekes, B.; de Herder, W.W.; Valk, G.D. Long-term natural course of pituitary tumors in patients with MEN1: results from the DutchMEN1 study group (DMSG). J. Clin. Endocrinol. Metab., 2015, 100(9), 3288-3296. [LoE
[] [PMID: 26126205]
Pivonello, R.; Auriemma, R.S.; Grasso, L.F.; Pivonello, C.; Simeoli, C.; Patalano, R.; Galdiero, M.; Colao, A. Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities. Pituitary, 2017, 20(1), 46-62. [no LoE
[] [PMID: 28224405]
Warszawski, L.; Kasuki, L.; Sá, R.; Dos Santos Silva, C.M.; Volschan, I.; Gottlieb, I.; Pedrosa, R.C.; Gadelha, M.R. Low frequency of cardiac arrhythmias and lack of structural heart disease in medically-naïve acromegaly patients: A prospective study at baseline and after 1 year of somatostatin analogs treatment. Pituitary, 2016, 19(6), 582-589. [LoE
[] [PMID: 27591859]
Ramos-Leví, A.M.; Marazuela, M. Cardiovascular comorbidities in acromegaly: An update on their diagnosis and management. Endocrine, 2017, 55(2), 346-359. [no LoE
[] [PMID: 28042644]
Colao, A. Improvement of cardiac parameters in patients with acromegaly treated with medical therapies. Pituitary, 2012, 15(1), 50-58. [no LoE
[] [PMID: 21713528]
Sharma, A.N.; Tan, M.; Amsterdam, E.A.; Singh, G.D. Acromegalic cardiomyopathy: Epidemiology, diagnosis, and management. Clin. Cardiol., 2018, 41(3), 419-425. [no LoE
[] [PMID: 29574794]
Colao, A.; Spinelli, L.; Marzullo, P.; Pivonello, R.; Petretta, M.; Di Somma, C.; Vitale, G.; Bonaduce, D.; Lombardi, G. High prevalence of cardiac valve disease in acromegaly: An observational, analytical, case-control study. J. Clin. Endocrinol. Metab., 2003, 88(7), 3196-3201. [LoE ςςς□
[] [PMID: 12843165]
Parolin, M.; Dassie, F.; Martini, C.; Mioni, R.; Russo, L.; Fallo, F.; Rossato, M.; Vettor, R.; Maffei, P.; Pagano, C. Preclinical markers of atherosclerosis in acromegaly: A systematic review and meta-analysis. Pituitary, 2018, 21(6), 653-662. [LoE ςςς□
[] [PMID: 30225826]
Oshino, S.; Nishino, A.; Suzuki, T.; Arita, H.; Tateishi, A.; Matsumoto, K.; Shimokawa, T.; Kinoshita, M.; Yoshimine, T.; Saitoh, Y. Prevalence of cerebral aneurysm in patients with acromegaly. Pituitary, 2013, 16(2), 195-201. [LoE
[] [PMID: 22752346]
Manara, R.; Maffei, P.; Citton, V.; Rizzati, S.; Bommarito, G.; Ermani, M.; Albano, I.; Della Puppa, A.; Carollo, C.; Pavesi, G.; Scanarini, M.; Ceccato, F.; Sicolo, N.; Mantero, F.; Scaroni, C.; Martini, C. Increased rate of intracranial saccular aneurysms in acromegaly: An MR angiography study and review of the literature. J. Clin. Endocrinol. Metab., 2011, 96(5), 1292-1300. [LoE
[] [PMID: 21307138]
Manara, R.; Gabrieli, J.; Citton, V.; Ceccato, F.; Rizzati, S.; Bommarito, G.; Briani, C.; Della Puppa, A.; Dassie, F.; Milanese, L.; Di Salle, F.; Ermani, M.; Scaroni, C.; Martini, C.; Maffei, P. Intracranial internal carotid artery changes in acromegaly: A quantitative magnetic resonance angiography study. Pituitary, 2014, 17(5), 414-422. [LoE
[] [PMID: 24068454]
Melmed, S.; Casanueva, F.F.; Klibanski, A.; Bronstein, M.D.; Chanson, P.; Lamberts, S.W.; Strasburger, C.J.; Wass, J.A.; Giustina, A. A consensus on the diagnosis and treatment of acromegaly complications. Pituitary, 2013, 16(3), 294-302. [no LoE
[] [PMID: 22903574]
Giustina, A.; Barkan, A.; Beckers, A.; Biermasz, N.; Biller, B.M.K.; Boguszewski, C.; Bolanowski, M.; Bonert, V.; Bronstein, M.D.; Casanueva, F.F.; Clemmons, D.; Colao, A.; Ferone, D.; Fleseriu, M.; Frara, S.; Gadelha, M.R.; Ghigo, E.; Gurnell, M.; Heaney, A.P.; Ho, K.; Ioachimescu, A.; Katznelson, L.; Kelestimur, F.; Kopchick, J.; Krsek, M.; Lamberts, S.; Losa, M.; Luger, A.; Maffei, P.; Marazuela, M.; Mazziotti, G.; Mercado, M.; Mortini, P.; Neggers, S.; Pereira, A.M.; Petersenn, S.; Puig-Domingo, M.; Salvatori, R.; Shimon, I.; Strasburger, C.; Tsagarakis, S.; van der Lely, A.J.; Wass, J.; Zatelli, M.C.; Melmed, S. A Consensus on the diagnosis and treatment of acromegaly comorbidities: an update. J. Clin. Endocrinol. Metab., 2020, 105(4), e937-e946. [No LoE
[] [PMID: 31606735]
Attal, P.; Chanson, P. Endocrine aspects of obstructive sleep apnea. J. Clin. Endocrinol. Metab., 2010, 95(2), 483-495. [LoE
[] [PMID: 20061419]
Galerneau, L.M.; Pépin, J.L.; Borel, A.L.; Chabre, O.; Sapene, M.; Stach, B.; Girey-Rannaud, J.; Arnol, N.; Tamisier, R.; Caron, P. Scientific council and investigators of the French national sleep apnoea registry (OSFP). Acromegaly in sleep apnoea patients: a large observational study of 755 patients. Eur. Respir. J., 2016, 48(5), 1489-1492. [LoE
Woodmansee, W.W.; Gordon, M.B.; Molitch, M.E.; Ioachimescu, A.G.; Carver, D.W.; Mirakhur, B.; Cox, D.; Salvatori, R. Screening for comorbid conditions in patients enrolled in the SODA registry: a 2-year observational analysis. Endocrine, 2018, 61(1), 105-117. [LoE
[] [PMID: 29767287]
De Menis, E.; Giustina, A.; Colao, A.; Degli Uberti, E.; Ghigo, E.; Minuto, F.; Bogazzi, F.; Drigo, R.; Cattaneo, A.; Aimaretti, G. COM.E.T.A. Italian Study Group. Assessment of the awareness and management of sleep apnea syndrome in acromegaly. The COM.E.TA Italian study group. J. Endocrinol. Invest., 2011, 34(1), 60-64. [LoE
Castellani, C.; Francia, G.; Dalle Carbonare, L.; Ferrari, M.; Viva, E.; Cerini, R.; Zaccarella, A.; Trevisiol, L.; Davì’, M.V. Morphological study of upper airways and long-term follow-up of obstructive sleep apnea syndrome in acromegalic patients. Endocrine, 2016, 51(2), 308-316. [LoE
[] [PMID: 26093846]
Berg, C.; Wessendorf, T.E.; Mortsch, F.; Forsting, M.; Teschler, H.; Weischer, T.; Mann, K.; Saller, B.; Herrmann, B.L. Influence of disease control with pegvisomant on sleep apnoea and tongue volume in patients with active acromegaly. Eur. J. Endocrinol., 2009, 161(6), 829-835. [LoE
[] [PMID: 19773369]
Pagano, C.; Parolin, M.; Dassie, F.; Alessio, L.; Wennberg, A.; Vettor, R.; Rossato, M.; Maffei, P. Obstructive sleep apnea in acromegaly and the effect of treatment: a systematic review and meta-analysis. J. Clin. Endocrinol. Metab., 2020, 105(3), e23-e31. [LoE ςςς□
Dreval, A.V.; Trigolosova, I.V.; Misnikova, I.V.; Kovalyova, Y.A.; Tishenina, R.S.; Barsukov, I.A.; Vinogradova, A.V.; Wolffenbuttel, B.H. Prevalence of diabetes mellitus in patients with acromegaly. Endocr. Connect., 2014, 3(2), 93-98. [LoE
[] [PMID: 24692509]
Abreu, A.; Tovar, A.P.; Castellanos, R.; Valenzuela, A.; Giraldo, C.M.; Pinedo, A.C.; Guerrero, D.P.; Barrera, C.A.; Franco, H.I.; Ribeiro-Oliveira, A., Jr; Vilar, L.; Jallad, R.S.; Duarte, F.G.; Gadelha, M.; Boguszewski, C.L.; Abucham, J.; Naves, L.A.; Musolino, N.R.; de Faria, M.E.; Rossato, C.; Bronstein, M.D. Challenges in the diagnosis and management of acromegaly: A focus on comorbidities. Pituitary, 2016, 19(4), 448-457. [no LoE
[] [PMID: 27279011]
Vilar, L.; Vilar, C.F.; Lyra, R.; Lyra, R.; Naves, L.A. Acromegaly: clinical features at diagnosis. Pituitary, 2017, 20(1), 22-32. [no LoE
[] [PMID: 27812777]
Boguszewski, C.L.; Ayuk, J. Acromegaly and cancer risk: an old debate revisited. Eur. J. Endocrinol., 2016, 175(4), R147-R156. [no LoE
[] [PMID: 27089890]
Dal, J.; Leisner, M.Z.; Hermansen, K.; Farkas, D.K.; Bengtsen, M.; Kistorp, C.; Nielsen, E.H.; Andersen, M.; Feldt-Rasmussen, U.; Dekkers, O.M.; Sørensen, H.T.; Jørgensen, J.O.L. Cancer incidence in patients with acromegaly: a cohort study and meta-analysis of the literature. J. Clin. Endocrinol. Metab., 2018, 103(6), 2182-2188. [LoE ςςς□
[] [PMID: 29590449]
Petroff, D.; Tönjes, A.; Grussendorf, M.; Droste, M.; Dimopoulou, C.; Stalla, G.; Jaursch-Hancke, C.; Mai, M.; Schopohl, J.; Schöfl, C. The incidence of cancer among acromegaly patients: results from the German Acromegaly Registry. J. Clin. Endocrinol. Metab., 2015, 100(10), 3894-3902. [LoE ςςς□
[] [PMID: 26244491]
Terzolo, M.; Reimondo, G.; Berchialla, P.; Ferrante, E.; Malchiodi, E.; De Marinis, L.; Pivonello, R.; Grottoli, S.; Losa, M.; Cannavò, S.; Ferone, D.; Montini, M.; Bondanelli, M.; De Menis, E.; Martini, C.; Puxeddu, E.; Velardo, A.; Peri, A.; Faustini-Fustini, M.; Tita, P.; Pigliaru, F.; Peraga, G.; Borretta, G.; Scaroni, C.; Bazzoni, N.; Bianchi, A.; Berton, A.; Serban, A.L.; Baldelli, R.; Fatti, L.M.; Colao, A.; Arosio, M. Italian Study Group of Acromegaly. Acromegaly is associated with increased cancer risk: A survey in Italy. Endocr. Relat. Cancer, 2017, 24(9), 495-504. [LoE ςςς□
[] [PMID: 28710115]
Lois, K.; Bukowczan, J.; Perros, P.; Jones, S.; Gunn, M.; James, R.A. The role of colonoscopic screening in acromegaly revisited: Review of current literature and practice guidelines. Pituitary, 2015, 18(4), 568-574. [no LoE
[] [PMID: 25052731]
Resmini, E.; Tagliafico, A.; Bacigalupo, L.; Giordano, G.; Melani, E.; Rebora, A.; Minuto, F.; Rollandi, G.A.; Ferone, D. Computed tomography colonography in acromegaly. J. Clin. Endocrinol. Metab., 2009, 94(1), 218-222. [LoE ς□□□
[] [PMID: 18957501]
Ramos, O., Jr; Boguszewski, C.L.; Teixeira, S.; De Bem, R.; Parolim, B.; Prolla, J.C. Performance of computed tomographic colonography for the screening of colorectal polyp in acromegalic patients: A prospective study. Arq. Gastroenterol., 2009, 46(2), 90-96. [LoE ς□□□
Colonna, M.; Uhry, Z.; Guizard, A.V.; Delafosse, P.; Schvartz, C.; Belot, A.; Grosclaude, P. FRANCIM network. Recent trends in incidence, geographical distribution, and survival of papillary thyroid cancer in France. Cancer Epidemiol., 2015, 39(4), 511-518. [LoE ςςς□
[] [PMID: 26003877]
Vaccarella, S.; Franceschi, S.; Bray, F.; Wild, C.P.; Plummer, M.; Dal Maso, L. Worldwide thyroid-cancer epidemic? The increasing impact of overdiagnosis. N. Engl. J. Med., 2016, 375(7), 614-617. [no LoE
[] [PMID: 27532827]
Aydin, K.; Aydin, C.; Dagdelen, S.; Tezel, G.G.; Erbas, T. Genetic alterations in differentiated thyroid cancer patients with acromegaly. Exp. Clin. Endocrinol. Diabetes, 2016, 124(3), 198-202. [LoE ς□□□
[] [PMID: 26575115]
Giustina, A.; Mazziotti, G.; Canalis, E. Growth hormone, insulin-like growth factors, and the skeleton. Endocr. Rev., 2008, 29(5), 535-559. [no LoE
[] [PMID: 18436706]
Bima, C.; Chiloiro, S.; Mormando, M.; Piacentini, S.; Bracaccia, E.; Giampietro, A.; Tartaglione, L.; Bianchi, A.; De Marinis, L. Understanding the effect of acromegaly on the human skeleton. Expert Rev. Endocrinol. Metab., 2016, 11(3), 263-270. [no LoE
Chiloiro, S.; Mormando, M.; Bianchi, A.; Giampietro, A.; Milardi, D.; Bima, C.; Grande, G.; Formenti, A.M.; Mazziotti, G.; Pontecorvi, A.; Giustina, A.; De Marinis, L. Prevalence of morphometric vertebral fractures in “difficult” patients with acromegaly with different biochemical outcomes after multimodal treatment. Endocrine, 2018, 59(2), 449-453. [LoE
[] [PMID: 28836162]
Mazziotti, G.; Bianchi, A.; Porcelli, T.; Mormando, M.; Maffezzoni, F.; Cristiano, A.; Giampietro, A.; De Marinis, L.; Giustina, A. Vertebral fractures in patients with acromegaly: A 3-year prospective study. J. Clin. Endocrinol. Metab., 2013, 98(8), 3402-3410. [LoE ςςς□
[] [PMID: 23771918]
Mazziotti, G.; Biagioli, E.; Maffezzoni, F.; Spinello, M.; Serra, V.; Maroldi, R.; Floriani, I.; Giustina, A. Bone turnover, bone mineral density, and fracture risk in acromegaly: A meta-analysis. J. Clin. Endocrinol. Metab., 2015, 100(2), 384-394. [LoE ςςς□
[] [PMID: 25365312]
Chiloiro, S.; Mazziotti, G.; Giampietro, A.; Bianchi, A.; Frara, S.; Mormando, M.; Pontecorvi, A.; Giustina, A.; De Marinis, L. Effects of pegvisomant and somatostatin receptor ligands on incidence of vertebral fractures in patients with acromegaly. Pituitary, 2018, 21(3), 302-308. [LoE ςςς□
[] [PMID: 29397538]
Mazziotti, G.; Lania, A.G.A.; Canalis, E. Bone disorders associated with acromegaly: mechanisms and treatment. Eur. J. Endocrinol., 2019, 181(2), R45-R56. [no LoE
Claessen, K.M.J.A.; Mazziotti, G.; Biermasz, N.R.; Giustina, A. Bone and joint disorders in acromegaly. Neuroendocrinology, 2016, 103(1), 86-95. [no LoE
[] [PMID: 25633971]
Fatti, L.M.; Cangiano, B.; Vitale, G.; Persani, L.; Mantovani, G.; Sala, E.; Arosio, M.; Maffei, P.; Dassie, F.; Mormando, M.; Giampietro, A.; Tanda, L.; Masiello, E.R.; Nazzari, E.; Ferone, D.; Corbetta, S.; Passeri, E.; Guaraldi, F.; Grottoli, S.; Cannavò, S.; Torre, M.L.T.; Soranna, D.; Zambon, A.; Cavagnini, F. Scacchi, M Study Group on Motor Disability in Acromegaly of the Italian Society of Endocrinology. Arthropathy in acromegaly: a questionnaire-based estimation of motor disability and its relation with quality of life and work productivity. Pituitary, 2019, 22(5), 552-560. [LoE
Abucham, J.; Bronstein, M.D.; Dias, M.L. MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and pregnancy: A contemporary review. Eur. J. Endocrinol., 2017, 177(1), R1-R12. [no LoE
[] [PMID: 28292926]
Cozzi, R.; Attanasio, R.; Barausse, M. Pregnancy in acromegaly: a one-center experience. Eur. J. Endocrinol., 2006, 155(2), 279-284. [LoE ς□□□
[] [PMID: 16868141]
Caron, P.; Broussaud, S.; Bertherat, J.; Borson-Chazot, F.; Brue, T.; Cortet-Rudelli, C.; Chanson, P. Acromegaly and pregnancy: a retrospective multicenter study of 59 pregnancies in 46 women. J. Clin. Endocrinol. Metab., 2010, 95(10), 4680-4687. [LoE
[] [PMID: 20660047]
Dias, M.; Boguszewski, C.; Gadelha, M.; Kasuki, L.; Musolino, N.; Vieira, J.G.; Abucham, J. Acromegaly and pregnancy: a prospective study. Eur. J. Endocrinol., 2013, 170(2), 301-310. [LoE
[] [PMID: 24247731]
Jallad, R.S.; Shimon, I.; Fraenkel, M.; Medvedovsky, V.; Akirov, A.; Duarte, F.H.; Bronstein, M.D. Outcome of pregnancies in a large cohort of women with acromegaly. Clin. Endocrinol. (Oxf.), 2018, 88(6), 896-907. [LoE
[] [PMID: 29574986]
Chanson, P.; Vialon, M.; Caron, P. An update on clinical care for pregnant women with acromegaly. Expert Rev. Endocrinol. Metab., 2019, 14(2), 85-96. [no LoE
[] [PMID: 30696300]
Karaca, Z.; Yarman, S.; Ozbas, I.; Kadioglu, P.; Akturk, M.; Kilicli, F.; Dokmetas, H.S.; Colak, R.; Atmaca, H.; Canturk, Z.; Altuntas, Y.; Ozbey, N.; Hatipoglu, N.; Tanriverdi, F.; Unluhizarci, K.; Kelestimur, F. How does pregnancy affect the patients with pituitary adenomas: A study on 113 pregnancies from Turkey. J. Endocrinol. Invest., 2018, 41(1), 129-141. [LoE
[] [PMID: 28634705]
Maffei, P.; Tamagno, G.; Nardelli, G.B.; Videau, C.; Menegazzo, C.; Milan, G.; Calcagno, A.; Martini, C.; Vettor, R.; Epelbaum, J.; Sicolo, N. Effects of octreotide exposure during pregnancy in acromegaly. Clin. Endocrinol. (Oxf.), 2010, 72(5), 668-677. [LoE ς□□□
[] [PMID: 19769624]
van der Lely, A.J.; Gomez, R.; Heissler, J.F.; Åkerblad, A.C.; Jönsson, P.; Camacho-Hübner, C.; Kołtowska-Häggström, M. Pregnancy in acromegaly patients treated with pegvisomant. Endocrine, 2015, 49(3), 769-773. [LoE
[] [PMID: 25542184]
Haliloglu, O.; Dogangun, B.; Ozcabi, B.; Kural, H.U.; Keskin, F.E.; Ozkaya, H.M.; Pamukcu, F.C.; Bektas, E.; Poyraz, B.C.; Buber, H.; Evliyaoglu, O.; Kadioglu, P. General health status and intelligence scores of children of mothers with acromegaly do not differ from those of healthy mothers. Pituitary, 2016, 19(4), 391-398. [LoE ς□□□
[] [PMID: 27033692]

© 2024 Bentham Science Publishers | Privacy Policy