Clinical Manifestations and Diagnosis of Acromegaly

Table 1

Clinical manifestations of acromegaly.

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Mass effects of the tumor

 Headache

 Visual field defects

 Hyperprolactinemia

 Pituitary stalk section

 Hypopituitarism

 Hypothyroidism, hypogonadism, hypocortisolism

Systemic effects of GH/IGF-I excess

 Visceromegaly

 Soft tissue and skin changes

 Thickening of acral parts

 Increased skin thickness and soft tissue hypertrophy

 Hyperhidrosis/Oily texture

 Skin tags and acanthosis nigricans

Cardiovascular features

 Hypertrophy (biventricular or asymmetric septal)

 Congestive Heart Failure (systolic and/or diastolic)

 Coronary disease

 Arrhythmias

 Hipertensión

 Cardiomyopathy

Metabolic features

 Impaired glucose tolerance

 Diabetes mellitus

 Insulin resistance

Respiratory manifestations

 Macroglossia

 Jaw malocclusion

 Upper airway obstruction

 Sleep disturbances

 Sleep apnea (central and obstructive)

 Ventilatory dysfunction

Bone and joint manifestations

 Increased articular cartilage thickness

  Arthralgias and arthritis

 Carpal tunnel síndrome

 Osteopenia

Other endocrine consequences

 Goiter

 Hypercalciuria

 Galactorrhea

 Decrease libido, impotents

 Menstrual abnormalities

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Modified from Cordero and Barkan [61].