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Elisa Sala, Justin M Moore, Alvaro Amorin, Hector Martinez, Aprotim C Bhowmik, Layton Lamsam, Steven Chang, Scott G Soltys, Laurence Katznelson, Griffith R Harsh
Surgery is the primary treatment for acromegaly. However, surgery may not be curative of some tumors, particularly invasive macroadenomas. Adjuvant radiation, specifically robotic stereotactic radiosurgery (rSRS), may improve the endocrine outcome. We retrospectively reviewed hormonal and radiological data of 22 acromegalic patients with invasive macroadenomas treated with rSRS at Stanford University Medical Center between 2000 and 2016. Prior to treatment, the tumor's median maximal diameter was 19 mm (2...
February 10, 2018: Journal of Neuro-oncology
Mohana Rao Patibandla, Zhiyuan Xu, Jason P Sheehan
Stereotactic radiosurgery (SRS) is a well-established treatment modality for patients with acromegaly. Our previously published study demonstrated a median time to remission of 29 months. This study aims to identify factors affecting the timing of remission and also to quantify the rate of late remission. This is a retrospective analysis of acromegaly patients who underwent SRS between 1988 and 2016. Early and late remissions were defined based on our prior median remission time of 29 months. The median imaging and endocrine follow-ups are 66 and 104...
February 7, 2018: Journal of Neuro-oncology
Yu-Chen Chen, Hao-Wei Chen, Ming-Tan Chen, Chun-Hsiung Huang, Ching-Chia Li, Yung-Shun Juan, Hung-Lung Ke
Acromegaly is a rare disease associated with an increased risk of prostate enlargement. Severe prostate enlargement with severe lower urinary tract symptoms (LUTS) in an acromegalic patient is even more uncommon. Herein we report on a 55-year-old man who was diagnosed with acromegaly and prostate enlargement at 40 years of age. Transsphenoidal surgery, postoperative radiotherapy, and octreotide medical therapy failed to control the acromegaly, and growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels remained elevated...
February 5, 2018: Lower Urinary Tract Symptoms
Sema Ciftci Dogansen, Seher Tanrikulu, Gulsah Yenidunya Yalin, Sema Yarman
PURPOSE: To evaluate the gonadal functions and related factors in female patients with acromegaly at the time of diagnosis, the course of gonadal dysfunctions and pregnancies during the follow-up period, and the investigation of ovarian reserve with serum anti-Mullerian hormone (AMH) levels in patients with reproductive age. METHODS: Patients who were not menopausal at the time of acromegaly diagnosis (n = 47) were included in this study. Baseline gonadal status was evaluated retrospectively...
February 5, 2018: Endocrine
Sabrina Chiloiro, Gherardo Mazziotti, Antonella Giampietro, Antonio Bianchi, Stefano Frara, Marilda Mormando, Alfredo Pontecorvi, Andrea Giustina, Laura De Marinis
PURPOSE: Acromegalic osteopathy is an emerging complication of acromegaly characterized by increase in bone turnover, deterioration in bone microarchitecture and high risk of vertebral fractures (VFs). Somatostatin receptor ligands (SRLs) and pegvisomant (PegV) are used for treatment of acromegaly and there is evidence that both drugs may exert direct effects on peripheral targets regardless of biochemical control of disease. However, whether or not SRLs and PegV may directly influence skeletal health its is unknown...
February 3, 2018: Pituitary
Jaime Guevara-Aguirre, Alexandra Guevara, Iván Palacios, Mónica Pérez, Patricio Prócel, Enrique Terán
Along with its inherent properties in growth promotion, cell division and regeneration, growth hormone (GH) exerts a variety of miscellaneous and widespread actions on the human body after binding to its receptor (GHR). Indeed, GH influences the metabolism of carbohydrates, lipids and proteins; shapes body composition, influences cardiovascular profile, quality of life, and induces other direct and indirect physiologic effects. Besides this salutary actions, GH and its derived peptide insulin-like growth factor-I (IGF-I), main product of the GH/GHR interaction, have been implicated in the genesis of diseases such as cancer and insulin-resistant diabetes...
December 12, 2017: Growth Hormone & IGF Research
Daniel A Heinrich, Claudia Reinholz, Maximilian Bauer, Amanda Tufman, Richard Frohner, Jochen Schopohl, Martin Bidlingmaier, Robert P Kosilek, Martin Reincke, Harald J Schneider
PURPOSE: Recent epidemiologic studies suggest a high prevalence of acromegaly. The prevalence of obstructive sleep apnea syndrome (OSAS) in acromegaly patients ranges from 47 to 70%. A recent study identified 2 patients with acromegaly among 567 OSAS patients. However, it remains unclear whether screening for acromegaly among OSAS patients is necessary. The aim was to screen for acromegaly among OSAS patients by measuring IGF-1 levels and performing confirmatory tests if necessary. METHODS: We performed a prospective cross-sectional diagnostic study on the prevalence of acromegaly in patients with OSAS...
January 31, 2018: Endocrine
N Reisch, M Reincke
Endocrine paraneoplastic syndromes result from the production of bioactive substances from neoplastic cells, of endocrine or neuroendocrine origin. Typically these are located in the lungs, the gastrointestinal tract, pancreas, thyroid gland, adrenal medulla, skin, prostate or breast. In endocrine paraneoplastic syndromes the secretion of peptides, amines or other bioactive substances is always ectopic and not related to the anatomical source. The clinical presentation, however, is indistinguishable from a suspected eutopic endocrine tumor posing a diagnostic challenge...
January 31, 2018: Der Internist
Zhaoyun Zhang, Qin Li, Wenqiang He, Huijia Qiu, Hongying Ye, Yongfei Wang, Ming Shen, Min He, Yifei Yu, Xuefei Shou, Chuanxin Huang, Huan Yu, Guoqian Huang, Weijun Tang, Daoying Geng, Chaowei Fu, Congjin Liu, Zengyi Ma, Zhao Ye, Qilin Zhang, Yichao Zhang, Yue Shen, Yeping Yang, Meng Wang, Xingdang Liu, Yun Lu, Hu R Ming, Ying Mao, Liangfu Zhou, Yi-Ming Li, Shiqi Li, Nicholas A Tritos, Yao Zhao
CONTEXT: Chronic excess of growth hormone (GH) often leads to systemic complications. The reversibility of these complications after GH resolution is not fully understood. OBJECTIVE: To investigate when and to what extent will the comorbidities be ameliorated. DESIGN: We conducted a prospective study comprising 24 patients with acromegaly, who achieved remission after transsphenoidal surgery. The dynamic changes of endocrine, cardiovascular, respiratory, sleep, bone and morphology parameters were evaluated at enrollment and 1 week, 1 month, 3 months, 6 months and 12 months after surgery...
January 31, 2018: European Journal of Endocrinology
Maria Caroline Alves Coelho, Marina Lipkin Vasquez, Luiz Eduardo Wildemberg, Mari C Vázquez-Borrego, Luciana Bitana, Aline Helen da Silva Camacho, Débora Silva, Liana Lumi Ogino, Nina Ventura, Leila Chimelli, Raul M Luque, Leandro Kasuki, Mônica R Gadelha
β-arrestins seem to have a role in endocytosis and desensitization of somatostatin receptor subtype 2 (sst2) and could be associated with the responsiveness to somatostatin receptor ligands (SRL) in patients with acromegaly. To investigate the in vivo correlation between β-arrestins 1 and 2 with sst2, sst5 and dopamine receptor subtype 2 (D2) expressions, and the association of β-arrestins with response to first-generation SRL and invasiveness in somatotropinomas. β-arrestins 1 and 2, sst2, sst5 and D2 mRNA expressions were evaluated by quantitative real-time RT-PCR on tumoral tissue of 96 patients...
January 27, 2018: Journal of Cellular and Molecular Medicine
Zhanna Belaya, Tatiana Grebennikova, Galina A Melnichenko, Alexey Nikitin, Alexander Solodovnikov, Olga Brovkina, Andrey Grigoriev, Liudmila Rozhinskaya, Alexander Lutsenko, Ivan I Dedov
OBJECTIVE: To evaluate the response of bone to chronic long-term growth hormone (GH) and insulin-like growth factor-1 (IGF1) excess by measuring the expression of selected mRNA and microRNA (miR) in bone samples of patients with active acromegaly. DESIGN: case-control study Methods: bone samples were obtained during transsphenoidal adenomectomy from the sphenoid bone (sella turcica) from 14 patients with clinically and biochemically-confirmed acromegaly and 10 patients with clinically non-functioning pituitary adenoma (NFPA) matched by sex and age...
January 26, 2018: European Journal of Endocrinology
F Tortosa, S M Webb
OBJECTIVES: To analyse the prognostic value of telomerase expression in patients with pituitary adenomas (PAs) followed-up for at least 8 years. PATIENTS AND METHODS: A retrospective study was conducted of samples from 51 PAs (40 typical and 11 atypical) from patients who underwent transsphenoidal surgery between 2006 and 2008 and from 10 normal pituitary glands obtained by autopsy. Telomerase expression was assessed by immunohistochemistry, correlating the expression with that of Ki-67 and p53...
January 17, 2018: Revista Clínica Española
Christian J Strasburger, Anders F Mattsson, Patrick Wilton, Ferah Aydin, Judith Hey-Hadavi, Beverly M K Biller
Pegvisomant monotherapy is effective and safe in treatment of acromegaly.1,2 However, some clinicians combine pegvisomant with somatostatin analogues(SSA) or dopamine agonist(DA).2,3 In this analysis of ACROSTUDY, a long-term non-interventional study, the use of combination regimens was evaluated. Based on their baseline treatment, 2043 patients were retrospectively categorized as: long-acting SSA combined with pegvisomant, "Combo SSA" 768 patients(38%); DA combined with pegvisomant, "Combo DA" 123(6%); Pegvisomant monotherapy, "Peg mono" 1128(55%)...
January 25, 2018: European Journal of Endocrinology
Betina Biagetti, Gabriel Obiols, Elena Martinez Saez, Esteban Cordero, Jordi Mesa
No abstract text is available yet for this article.
January 19, 2018: Endocrinología, Diabetes y Nutrición
Ana Amado, Fernando Araújo, Davide Carvalho
OBJECTIVE: Cardiovascular disease is one of the most important causes of death in acromegalic patients. The aim of this study is to compare the prevalence of cardiovascular risk factors among acromegalic patients and to evaluate the impact of disease control on these factors. MATERIAL AND METHODS: 11 acromegalic patients with active disease and 12 controlled patients were evaluated for blood pressure, body mass index, glucose, coagulation status, and lipid profile...
January 24, 2018: Experimental and Clinical Endocrinology & Diabetes
A Ciresi, S Radellini, V Guarnotta, C Giordano
BACKGROUND: The approach to acromegalic patients with persistent acromegaly after surgery and inadequate response to first-generation somatostatin receptor ligands (SRLs) should be strictly tailored. Current options include new pituitary surgery and/or radiosurgery, or alternative medical treatment with SRLs high dose regimens, pegvisomant (PEG) as monotherapy, or combined therapy with the addition of PEG or cabergoline to SRLs. A new pharmacological approach includes pasireotide, a second-generation SRL approved for patients who do not adequately respond to surgery and/or for whom surgery is not an option...
January 24, 2018: BMC Endocrine Disorders
Hussain Alquraini, Maria Del Pilar Schneider, Beloo Mirakhur, Ariel Barkan
PURPOSE: In clinical research involving acromegalic patients naïve to somatostatin-receptor ligands (SRLs), 19 and 31% of those receiving the SRLs octreotide LAR and pasireotide LAR, respectively, achieved GH < 2.5 ng/mL + normalized IGF-1 concentrations. The proportions achieving control appeared higher in the post-surgery compared with the de-novo setting with pasireotide, but more similar with octreotide. Using pooled data from multicenter clinical trials, we examined the biochemical efficacy of lanreotide depot/Autogel in similar settings...
January 22, 2018: Pituitary
Sara Tellatin, Pietro Maffei, Elena Osto, Francesca Dassie, Giulia Famoso, Roberta Montisci, Chiara Martini, Francesco Fallo, Martina Perazzolo Marra, Roberto Mioni, Sabino Iliceto, Roberto Vettor, Francesco Tona
BACKGROUND AND AIMS: Acromegaly increases the risk of cardiovascular mortality. Data on the cardiovascular risk in asymptomatic acromegaly are limited. In particular, data on coronary microvascular abnormalities are lacking. We assessed coronary flow reserve (CFR) as a marker of coronary microvascular function in asymptomatic acromegaly. METHODS: We studied 40 acromegalic patients (23 male, age 52 ± 11 years) without clinical evidence of cardiovascular disease, and 40 control subjects matched for age and sex...
December 24, 2017: Atherosclerosis
Leandro Kasuki, Luiz Eduardo Wildemberg, Mônica R Gadelha
Acromegaly is associated with high morbidity and elevated mortality when not adequately treated. Surgery is the first-line treatment for most patients as it is the only one that can lead to immediate cure. In patients who are not cured by surgery, treatment is currently based on a trial-and-error approach. First-generation somatostatin receptor ligands (fg-SRL) are initiated for most patients, although approximately 25% of patients present resistance to this drug class. Some biomarkers of treatment outcome are described in the literature, with the aim of categorizing patients into different groups to individualize their treatments using a personalized approach...
March 2018: European Journal of Endocrinology
Maria Piagkou, Othon Manolakos, Theodore Troupis, Nikolaos Lazaridis, Konstantinos Laios, Alexandros Samolis, Konstantinos Natsis
OBJECTIVE: This study adds important information regarding the morphological alterations caused by growth hormone hypersecretion in the skull and craniocervical junction (CCJ). A variably asymmetric skull due to acromegaly coexists with expansion of the paranasal sinuses and multiple Wormian bones. CASE REPORT: A pathologically asymmetric dry skull of a European male, aged 38 years at death, with cranial vault and skull base thickening is described. The extensive paranasal sinus pneumatization caused a generalized thinning of the bony walls...
November 2017: Acta Medica Academica
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