Akromegali

Akromegali aşırı büyüme hormonu (BH) salınımı sonucu ortaya çıkan klinik sendromdur. Akromegalinin en sık nedeni ön hipofizde BH salgılayan adenomdur. Akromegali başlangıcı sinsi ve genellikle yavaş seyirlidir. Hemen hemen tüm hastalarda akral kemik ve yumuşak dokularda aşırı büyüme mevcuttur. Karakteristik bulgular alt çene çıkıklığı, el ve ayak büyümesidir. Akromegali hastalarında kardiyovasküler hastalık, kolon kanseri, tiroid kanseri ve diğer tümörlerde risk artışı görülmektedir. Ölüm genellikle kardiyovasküler hastalıklar nedeniyle olmaktadır. Akromegalinin temel tedavisi transsfenoidal cerrahidir. Cerrahi sonrası kür sağlanmazsa uzun etkili somatostatin analogları, kabergolin, pegvisomant gibi medikal tedaviler kullanılır. Medikal tedaviye rağmen BH/IGF-1 veya adenom boyutunda artış olursa reoperasyon veya radyoterapi kullanılabilir.

Anahtar Kelimeler:

Akromegali, tanı, tedavi

Acromegaly

Acromegaly is the clinical syndrome that results from excessive secretion of growth hormone (GH). The most common cause of acromegaly is a GH secreting adenoma of the anterior pituitary. The onset of acromegaly is insidious, and its progression is usually very slow. Nearly all patients with acromegaly have acral osseous and soft tissue overgrowth. The characteristic findings are an enlarged jaw and enlarged, swollen hands and feet. Patients with acromegaly appear to be at increased risk for cadiovascular disase, colon cancer, thyroid cancer and other tumors. Death is generally caused by cardiovascular diseases. Transsphenoidal surgery is the main therapy for patients with an acromegaly. After surgical failure long-acting somatostatin analog, cabergolin or pegvisomant are indicated. If adenoma size increases or GH/IGF-1 hypersecretion persists despite medical therapy, we suggest radiation therapy (RT) or repeat surgery.

Keywords:

Acromegaly, diagnosis, treatment,

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