Endocrinological diagnosis in acromegaly

Abstract Acromegaly is a slowly progressing and rare disease due to excessive growth hormone (GH) that stems from a pituitary adenoma in most cases. GH is a peptide hormone with anabolic functions related to growth, protein, lipid, and carbohydrate metabolism. Excess GH leads to increased IGF-I production mostly in the liver, an important mediator of GH effects, and a multitude of systemic complications. Overall mortality in untreated acromegaly is elevated in comparison with the general population. Clinical diagnosis is difficult as most presenting symptoms set in over years and are very nonspecific, such as fatigue, headaches, arthropathy, or impaired glucose tolerance. Elevated IGF-I levels and the failure to suppress GH secretion during an oral glucose tolerance test establish the diagnosis. Clinicians need to be careful when interpreting hormone levels as influencing factors may distort biochemical results. Lastly the tumor is localized with high-quality imaging, and the patient screened for concomitant disease.