Acromegaly Clinical Manifestations and Management

Introduction to Acromegaly

• Acromegaly presents with a wide range of clinical manifestations including characteristic somatic disfigurement, systemic manifestations, and metabolic dysfunction, all resulting from excess growth hormone (GH) and insulin-like growth factor I (IGF-I) levels 1

Cardiovascular Complications

• Heart failure is the most common cause of death in untreated acromegaly 2, 3
• Valvular heart disease is a specific complication 3
• Left ventricular hypertrophy may occur and can improve with treatment 3

Clinical Implications

• Elevated GH and IGF-I levels are predictors of mortality in acromegaly patients 1, 2
• Normalizing GH and IGF-I levels through treatment results in mortality rates similar to the general population 1, 2
• Regular colonoscopic screening is recommended starting at age 40 due to increased risk of colorectal neoplasia 3, 4

Diagnostic Confirmation

• Biochemical confirmation is essential through elevated IGF-I levels and failure to suppress GH during an oral glucose tolerance test 2