Growth hormone deficiency in treated acromegaly

Highlights • Growth hormone deficiency (GHD) may arise in patients with previous acromegaly as a consequence of overly effective neurosurgery and/or radiotherapy. • The insulin-tolerance test is the gold standard for diagnosis of GHD, and the response is independent of previous cranial irradiation f...

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Bibliographic Details
Published in:Trends in endocrinology and metabolism 2015-01, Vol.26 (1), p.11-21
Main Authors: Mazziotti, Gherardo, Marzullo, Paolo, Doga, Mauro, Aimaretti, Gianluca, Giustina, Andrea
Format: Article
Language:English
Subjects:
acromegaly
Acromegaly - complications
Acromegaly - epidemiology
Acromegaly - therapy
Adult
Endocrinology & Metabolism
growth hormone deficiency
Hormone Replacement Therapy
Human Growth Hormone - deficiency
Human Growth Hormone - therapeutic use
Humans
Hypopituitarism - diagnosis
Hypopituitarism - drug therapy
Hypopituitarism - epidemiology
Hypopituitarism - etiology
IGF-1
mortality
Neurosurgery
Postoperative Complications - diagnosis
Postoperative Complications - epidemiology
Postoperative Complications - etiology
radiotherapy
Risk Factors
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Summary:Highlights • Growth hormone deficiency (GHD) may arise in patients with previous acromegaly as a consequence of overly effective neurosurgery and/or radiotherapy. • The insulin-tolerance test is the gold standard for diagnosis of GHD, and the response is independent of previous cranial irradiation for hypothalamic-pituitary tumors. • The GH releasing hormone+arginine test is as effective as the insulin-tolerance test for diagnosing GHD in acromegaly patients treated by neurosurgery, as well as in those treated by radiotherapy 5 years following irradiation. • Patients who develop GHD after treatment of acromegaly may have an impairment of cardiovascular health and quality of life. • The risk/benefit ratio of replacement therapy for GHD in patients with a history of acromegaly is still uncertain.
ISSN:1043-2760
1879-3061
DOI:10.1016/j.tem.2014.10.005