What is the gold standard for diagnosing acromegaly?

An OGTT with 75 g glucose is considered the gold standard for diagnosing acromegaly. However, similar to IGF-1 assays, the GH assay method can impact the absolute GH concentration reported by a laboratory.

What is the best initial test to diagnose acromegaly?

Growth hormone suppression test. This is the best method for confirming an acromegaly diagnosis. During this test, your GH blood level is measured both before and after you drink a preparation of sugar (glucose).

How do you diagnosis acromegaly?

Doctors most often diagnose acromegaly by ordering two blood tests that help determine if your body is making too much GH.

  1. IGF test. Levels of GH in the blood can change throughout the day.
  2. Oral glucose tolerance test. To confirm the diagnosis, your doctor will order an oral glucose tolerance test.

What are the different test parameters used in diagnosing acromegaly?

Diagnosing acromegaly involves 2 key blood tests: a test to check the level of the insulin-like growth factor-1 (IGF-1) and an oral glucose tolerance test (OGTT). Doctors can’t simply test for the level of growth hormone (GH) in your body because the level varies so much in one day—even in someone without acromegaly.

How do you interpret Ogtt for acromegaly?

Interpretation: Growth hormone should suppress to <0.5 μg/litre in normal people (though a truly normal response is probably well below this level – some suggest <0.2 μg/litre). In acromegaly failure of suppression occurs, and there may be a paradoxical rise in GH in response to the glucose challenge.

What is the first line treatment for acromegaly?

Transsphenoidal surgery is the preferred first-line treatment for patients with acromegaly that have intrasellar microadenomas, noninvasive macroadenomas or patients in whom the tumor is causing compression symptoms.

When should you suspect acromegaly?

The diagnosis of acromegaly should be suspected in individuals who present with the typical clinical features of growth hormone (GH) excess, which include the enlargement during adulthood of the jaw (macrognathia), hands, and feet, which result in increasing shoe and glove size and the need to enlarge finger rings.

Which of the following is a symptom of acromegaly?

Symptoms of acromegaly swollen hands and feet – you may notice a change in your ring or shoe size. tiredness and difficulty sleeping, and sometimes sleep apnoea. gradual changes in your facial features, such as your brow, lower jaw and nose getting larger, or your teeth becoming more widely spaced.

What is acromegaly and its signs?

Symptoms of acromegaly include an enlarged face and hands. Changes to the face may cause the brow bone and lower jaw to protrude, and the nose and lips to get larger. Acromegaly is a hormonal disorder that develops when your pituitary gland produces too much growth hormone during adulthood.

How do you interpret OGTT for acromegaly?

What is the level of IGF-1 in acromegaly?

According to a recent consensus statement on multidisci- plinary management of acromegaly IGF-1 values up to 1.2–1.3× ULN range may also be considered sufficient for control of acromegaly [12]. Basal GH levels are measured in the morning after fasting and are usually elevated in patients with acromegaly [8].

What is the most effective cure for acromegaly?

Surgery. Surgery is usually effective and can completely cure acromegaly. But sometimes the tumour is too large to be removed entirely, and you may need another operation or further treatment with medicine or radiotherapy.

Who is most likely to get acromegaly?

Men and women are affected equally. Most people who are diagnosed with acromegaly are aged between 30 and 50 years of age. Very rarely, acromegaly can be diagnosed in children and adolescents. Children and adolescents will, however, develop gigantism, whereas adults develop acromegaly.

Who is most at risk for acromegaly?

Acromegaly is usually diagnosed in adults aged 30 to 50, but it can affect people of any age. When it develops before the end of puberty, it’s known as “gigantism”.

What is the most common cause of acromegaly?

Causes of acromegaly Acromegaly happens because your pituitary gland (a pea-sized gland just below the brain) produces too much growth hormone. This is usually caused by a non-cancerous tumour in the pituitary gland called an adenoma.

What can mimic acromegaly?

In summary, Sotos syndrome and other overgrowth syndromes can mimic the clinical manifestations of acromegaly or gigantism.

What is the life expectancy of someone with acromegaly?

In acromegaly, men were younger than women at diagnosis (median 44.5 vs 50 years, P<0.001) and death (67 vs 76 years, P=0.0015). Compared with controls, women (36% vs 25%, P<0.01), but not men (31% vs 28%, P=0.44), had increased mortality.

Which of the following are signs of acromegaly?

Symptoms

  • Enlarged hands and feet.
  • Enlarged facial features, including the facial bones, lips, nose and tongue.
  • Coarse, oily, thickened skin.
  • Excessive sweating and body odor.
  • Small outgrowths of skin tissue (skin tags)
  • Fatigue and joint or muscle weakness.
  • Pain and limited joint mobility.

Does acromegaly affect the brain?

Active acromegaly is a rare chronic endocrine disorder caused by excessive growth hormone (GH). Clinical studies suggest that cognitive performance is impaired in acromegaly – particularly executive function as well as short- and long-term memory.

What is pseudo acromegaly?

Pseudoacromegaly or acromegaloidism is a clinical condition characterised by physical signs suggestive of excess growth hormone (GH) but with normal functioning of the GH—insulin-like growth factor-1 (IGF-1) axis.