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[Title] Differential expression of microRNAs in GH-secreting pituitary adenomas.

BACKGROUND: The purpose of this study was to (1) identify specific miRNAs in growth hormones (GH)-secreting pituitary adenomas;.

METHODS: Fifteen GH-secreting adenomas patients were treated with lanreotide for 4 months before surgery.

Patients with 50% reduction of GH secretion by lanreotide were considered as SSA responders, while patients with less than 50% of GH reduction were considered as SSA nonresponders.

We analyzed the miRNAs in 21 GH-secreting pituitary adenomas and 6 normal pituitaries by miRCURY™ LNA array and some differentially expressed miRNAs were validated by quantitative real-time PCR.

RESULTS: Fifty-two miRNAs were differentially expressed between GH-secreting pituitary adenomas and normal pituitaries.

Differential expression of 9 miRNAs was observed between micro- and macro-adenomas.

Seven miRNAs were differentially expressed between SSA responders or GH nonresponders.

Several identified miRNAs may be involved in cell proliferation, apoptosis, cancer development and progression.

CONCLUSIONS: Our results indicate that altered miRNAs expression is involved in GH-secreting pituitary adenomas transformation, which will shed light on the mechanisms for the treatment of acromegaly by SSA.

Identification and characterization of the targets of altered miRNAs genes may elucidate molecular mechanisms involved in the pathogenesis of pituitary adenoma.

[MeSH-major] Adenoma / genetics. Gene Expression Profiling. Growth Hormone-Secreting Pituitary Adenoma / genetics. MicroRNAs / analysis

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(PMID = 21138567.001).

[ISSN] 1746-1596

[Journal-full-title] Diagnostic pathology

[ISO-abbreviation] Diagn Pathol

[Language] eng

[Databank-accession-numbers] ClinicalTrials.gov/ NCT00993356

[Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] England

[Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / MicroRNAs; 0 / Peptides, Cyclic; 0G3DE8943Y / lanreotide; 51110-01-1 / Somatostatin

[Other-IDs] NLM/ PMC3017030

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Surgical results of growth hormone-secreting pituitary adenoma.

OBJECTIVE: We retrospectively analyzed the surgical outcomes of 42 patients with growth hormone (GH)-secreting pituitary adenoma to evaluate the clinical manifestations and to determine which preoperative factors that significantly influence the remission.

METHODS: Forty-two patients with GH-secreting pituitary adenoma underwent transsphenoidal surgery (TSS) between 1995 and 2007.

For comparable radiological criteria, we classified parasellar growth into five grades according to the Knosp classification.

There was a significant relationship between preoperative mean GH concentration and early postoperative outcome, with most patients in remission having a lower preoperative GH concentration.

CONCLUSION: TSS is thought to be an effective primary treatment for GH-secreting pituitary adenomas according to the most recent criteria of cure.

Because the remission rate in cases with cavernous sinus invasion is very low, early detection of the tumor before it extends into the cavernous sinus and a long-term endocrinological and radiological follow-up are necessary in order to improve the remission rate of acromegaly.

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(PMID = 19516943.001).

[ISSN] 2005-3711

[Journal-full-title] Journal of Korean Neurosurgical Society

[ISO-abbreviation] J Korean Neurosurg Soc

[Language] eng

[Publication-type] Journal Article

[Publication-country] Korea (South)

[Other-IDs] NLM/ PMC2693785

[Keywords] NOTNLM ; Cavernous sinus / Growth hormone-secreting pituitary adenoma / Remission induction

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Elevation of growth hormone-releasing hormone receptor messenger ribonucleic acid expression in growth hormone-secreting pituitary adenoma with Gsalpha protein mutation.

Growth hormone-releasing hormone (GHRH) stimulates not only the synthesis and secretion of GH but also the proliferation of normal somatotrophs.

The expression of GHRH receptor (GHRHR) is regulated by GHRH, both of which are known to be expressed in human GH-secreting pituitary adenoma cells.

Somatic mutations in the subunit of Gsalpha protein (gsp), lead to the constitutive activation of adenylyl cyclase in pituitary adenomas that secrete GH.

It has not been examined how gsp mutations influence GHRHR expression in GH-secreting adenomas.

We therefore analyzed the expression levels of GHRHR messenger ribonucleic acid (mRNA) in GH-secreting pituitary adenomas focusing on a gsp mutation.

Furthermore, we investigated the effect of GHRH on the expression of GHRHR mRNA in primary cultures of GH-secreting pituitary adenoma cells.

GHRHR mRNA expression levels were significantly elevated in gsp mutation-positive GH-secreting adenomas compared with those in gsp mutation-negative ones.

In primary-cultured GH-secreting adenoma cells, the increase of GH secretion in response to GHRH was shown in both gsp mutation-positive and -negative adenoma cells with a significantly higher response in the latter adenoma cells.

GHRH increased GHRHR mRNA expression level in gsp mutation-negative adenoma cells while it was not influenced by GHRH in gsp mutation-positive adenoma cells.

These results suggest that gsp mutations up-regulate GHRHR mRNA expression in GH-secreting pituitary adenoma cells, and that gsp mutations desensitize the adenoma cells to GHRH in terms of their GHRHR mRNA expression probably because of their saturation of GHRH signaling.

[MeSH-major] Adenoma / genetics. GTP-Binding Protein alpha Subunits, Gs / genetics. Growth Hormone-Releasing Hormone / secretion. Mutation, Missense. Neoplasm Proteins / genetics. Nerve Tissue Proteins / genetics. Pituitary Neoplasms / genetics. Point Mutation. RNA, Messenger / biosynthesis. RNA, Neoplasm / biosynthesis. Receptors, Neuropeptide / genetics. Receptors, Pituitary Hormone-Regulating Hormone / genetics

[MeSH-minor] Acromegaly / etiology. Acromegaly / surgery. Adult. Amino Acid Substitution. Cell Line, Tumor / drug effects. Cell Line, Tumor / metabolism. Cell Line, Tumor / secretion. Female. Gene Expression Regulation, Neoplastic. Humans. Male. Middle Aged

Genetic Alliance. consumer health - Pituitary adenoma, growth hormone-secreting.

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(PMID = 19029774.001).

[ISSN] 1349-8029

[Journal-full-title] Neurologia medico-chirurgica

[ISO-abbreviation] Neurol. Med. Chir. (Tokyo)

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] Japan

[Chemical-registry-number] 0 / Neoplasm Proteins; 0 / Nerve Tissue Proteins; 0 / RNA, Messenger; 0 / RNA, Neoplasm; 0 / Receptors, Neuropeptide; 0 / Receptors, Pituitary Hormone-Regulating Hormone; 0 / somatotropin releasing hormone receptor; 9034-39-3 / Growth Hormone-Releasing Hormone; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs

   

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[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] A possible new syndrome with growth-hormone secreting pituitary adenoma, colonic polyposis, lipomatosis, lentigines and renal carcinoma in association with familial testicular germ cell malignancy: A case report.

BACKGROUND: Germ-cell testicular cancer has not been definitively linked to any known hereditary cancer susceptibility disorder.

His evaluation as part of an etiologic study of familial testicular cancer revealed multiple colon polyps (adenomatous, hyperplastic, and hamartomatous) first found in his 50 s, multiple lipomas, multiple hyperpigmented skin lesions, left kidney cancer diagnosed at age 64, and a growth-hormone producing pituitary adenoma with associated acromegaly diagnosed at age 64.

Alternatively, this family's phenotype might represent a novel neoplasm susceptibility disorder.

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(PMID = 17411461.001).

[Journal-full-title] Journal of medical case reports

[ISO-abbreviation] J Med Case Rep

[Language] ENG

[Grant] United States / NCI NIH HHS / CP / N02CP11019

[Publication-type] Journal Article

[Publication-country] England

[Other-IDs] NLM/ PMC1847830

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Does the response of GH-secreting pituitary adenomas to octreotide depend on the cellular localization of the somatostatin receptor subtypes SSTR2 and SSTR5?

INTRODUCTION: The immunohistochemical examination of somatostatin receptor (SSTR) subtypes expression in different endocrine tumours, including pituitary adenomas, revealed membranous or cytoplasmic distribution of SSTR1-5.

In an earlier study a positive correlation between the summarized score of SSTR2A + SSTR2B expressions and growth hormone (GH) response to octreotide administration was found, independently of receptor distribution within the cell.

In this study we searched for the relationship between the GH inhibitory response to acute octreotide administration and SSTR2A, SSTR2B, and SSTR5 cellular localization.

The drop in GH was defined as the percentage of the basal value.

The pituitary adenomas from these patients were immunostained to determine the hormonal phenotype and expression of SSTR subtypes.

The drop in GH after octreotide administration varied between 57.1-96.7% (mean 82.1%).

Among the patients with the cytoplasmic localization of SSTR5, the decrease in GH was significantly higher (92.0 +/- 7.0%).

CONCLUSIONS: It seems that cytoplasmic localization of SSTR5, SSTR2A, and SSTR2B is connected with enhanced GH inhibition after octreotide administration.

As a consequence, the SSTR-immunopositivity in cell cytoplasm is increased.

[MeSH-major] Adenoma / drug therapy. Adenoma / pathology. Octreotide / pharmacology. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / pathology. Receptors, Somatostatin / analysis

[MeSH-minor] Adult. Aged. Antineoplastic Agents, Hormonal / pharmacology. Chemotherapy, Adjuvant. Cytoplasm / pathology. Female. Growth Hormone / secretion. Humans. Immunohistochemistry. Male. Middle Aged. Tissue Distribution

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(PMID = 20464704.001).

[ISSN] 0423-104X

[Journal-full-title] Endokrynologia Polska

[ISO-abbreviation] Endokrynol Pol

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] Poland

[Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 9002-72-6 / Growth Hormone; RWM8CCW8GP / Octreotide

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Long-term (up to 18 years) effects on GH/IGF-1 hypersecretion and tumour size of primary somatostatin analogue (SSTa) therapy in patients with GH-secreting pituitary adenoma responsive to SSTa.

CONTEXT: The role of somatostatin analogues (SSTa) in the treatment of acromegaly.

OBJECTIVE: To evaluate the antihormonal and antitumour efficacy of long-term (up to 18 years) primary treatment with SSTa in patients with GH-secreting pituitary adenoma responsive to SSTa.

PATIENTS: Thirty-six acromegalic patients, aged 17-75 years (postoral glucose tolerance test GH > 1 microg/l, increased IGF-1 for age and sex), were monitored in a single centre and treated with SSTa as first-line therapy.

The mean pretreatment GH level was 13.5 +/- 3.1 microg/l, and IGF-1 (as a percentage of the value over the normal range) was 302 +/- 26%.

RESULTS: After 1 year, the mean GH and IGF-1 levels had reduced considerably (GH: 2.4 +/- 0.3 microg/l; IGF-1; 174 +/- 14%, P < 0.01), and they continued to decrease over 10 years, with a mean GH level of 1.6 +/- 0.1 microg/l and IGF-1 of 123 +/- 18% (P = 0.02).

GH < 2 microg/l, normal IGF-1, or both were observed in 25 (70%), 24 (67%) and 21 (58%) patients, respectively.

[MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Growth Hormone / blood. Growth Hormone-Secreting Pituitary Adenoma / drug therapy. Insulin-Like Growth Factor I / analysis. Pituitary Neoplasms / drug therapy. Somatostatin / analogs & derivatives

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(PMID = 17524029.001).

[ISSN] 0300-0664

[Journal-full-title] Clinical endocrinology

[ISO-abbreviation] Clin. Endocrinol. (Oxf)

[Language] eng

[Publication-type] Clinical Trial; Journal Article

[Publication-country] England

[Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Dopamine Agonists; 0 / Peptides, Cyclic; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone; RWM8CCW8GP / Octreotide

[Other-IDs] NLM/ PMC1974833

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Clival pituitary adenoma with acromegaly: case report and review of literature.

The pituitary develops as a result of complex, intricate, and precise neuro-embryological events in the sixth to eighth weeks of gestation.

Some ectopic cell rests can become adenomatous.

Rarely, these cell rests in the clivus can be the site of formation of adenoma.

Our patient, a 35-year-old parous woman, was being treated for acromegaly, and imaging studies revealed a clival mass lesion.

Trans-sphenoidal excision was done and immunohistochemistry revealed the tumor to be a growth hormone-secreting tumor.

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(PMID = 18174927.001).

[ISSN] 1531-5010

[Journal-full-title] Skull base : official journal of North American Skull Base Society ... [et al.]

[ISO-abbreviation] Skull Base

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

[Other-IDs] NLM/ PMC2039716

[Keywords] NOTNLM ; Acromegaly / clivus / pituitary tumor

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure?

OBJECT: The authors conducted a study to determine the long-term results of gamma knife surgery for residual or recurrent growth hormine (GH)-producing pituitary adenomas and to compare the results with those after treatment of other pituitary adenomas.

Growth hormone normalization (GH < 1.0 ng/ml) was found in 4.8%, nearly normal (< 2.0 ng/ml) in 11.9%, significantly decreased (< 5.0 ng/ml) in 23.8%, decreased in 21.4%, unchanged in 21.4%, and increased in 16.7%.

Serum insulin-like growth factor (IGF)-1 was significantly decreased (IGF-1 < 400 ng/ml) in 40.7%, decreased in 29.6%, unchanged in 18.5%, and increased in 11.1%, which was almost parallel to the GH changes.

CONCLUSIONS: Gamma knife surgery was effective and safe for the control of tumors; however, normalization of GH and IGF-1 secretion was difficult to achieve in cases with large tumors and low-dose radiation.

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(PMID = 28306435.001).

[ISSN] 1933-0693

[Journal-full-title] Journal of neurosurgery

[ISO-abbreviation] J. Neurosurg.

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

[Keywords] NOTNLM ; gamma knife surgery / growth hormone—producing pituitary adenoma / insulin-like growth factor

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Does the prevalence of gsp mutations in GH-secreting pituitary adenomas differ geographically or racially? Prevalence of gsp mutations in Japanese patients revisited.

OBJECTIVE: The prevalence of gsp mutations in GH-secreting pituitary adenomas was thought to differ geographically or racially, given its exceptionally lower incidence among Japanese patients (4.4-9.3%) compared to other regions (30-50%).

However, this notion is now being challenged after a recent paper reported a 53.3% incidence among Japanese with acromegaly.

PATIENTS: One hundred Japanese acromegaly patients with surgically confirmed GH-secreting pituitary adenomas were enrolled.

METHODS: mRNAs from primary cultured adenomas were used for reverse transcriptase-polymerase chain reaction and direct sequencing of the Gsalpha subunit.

Age at operation, sex ratio, basal serum GH and IGF-I levels were no different with or without the mutations.

In contrast, patients responded differently to most dynamic tests with statistical significance: serum GH levels in gsp-positive patients had blunted response to GHRH, were well suppressed by bromocriptine, and had higher rates of paradoxical response to TRH.

Octreotide suppressed GH levels strongly regardless of gsp status.

CONCLUSION: We conclude that the prevalence of gsp mutations in Japanese acromegaly patients is comparable to those of other reports from various regions.

Therefore, Japanese patients do not stand as an example for geographical or racial difference in the prevalence of gsp mutations in GH-secreting pituitary adenomas.

[MeSH-major] Adenoma / genetics. GTP-Binding Protein alpha Subunits, Gs / genetics. Pituitary Neoplasms / genetics. Point Mutation

[MeSH-minor] Acromegaly / ethnology. Acromegaly / metabolism. Adult. Asian Continental Ancestry Group. DNA Mutational Analysis. Female. Growth Hormone / blood. Growth Hormone / secretion. Growth Hormone-Releasing Hormone. Humans. Insulin-Like Growth Factor I / analysis. Japan. Male. Middle Aged. Prevalence. Reverse Transcriptase Polymerase Chain Reaction. Sequence Analysis, DNA. Statistics, Nonparametric

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(PMID = 16402935.001).

[ISSN] 0300-0664

[Journal-full-title] Clinical endocrinology

[ISO-abbreviation] Clin. Endocrinol. (Oxf)

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] England

[Chemical-registry-number] 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone; 9034-39-3 / Growth Hormone-Releasing Hormone; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Severe cardiovascular complications due to the pituitary adenoma with acromegaly. An interdisciplinary approach to the treatment. A case report].

[Transliterated title] Ciezkie powikłania sercowo-naczyniowe w przebiegu guza przysadki powodujacego akromegalie. Propozycja równoczesnego wielospecjalistycznego leczenia. Opis przypadku.

Acromegaly reduces life expectancy and leads to 3-5-fold increase in mortality.

Successful therapy ought to normalize GH, IGF-I secretion, remove the adenoma mass and its local pressure effects and preserve pituitary functions intact to improve systemic morbidity and normalize mortality.

The primary therapy for most patients with acromegaly is still transsphenoidal adenomectomy.

The authors present a 64-year-old woman with diagnosed GH-secreting pituitary macroadenoma suffering from severe coronary heart disease and diabetes mellitus.

[MeSH-major] Acromegaly / surgery. Adenoma / surgery. Coronary Artery Disease / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. Pituitary Neoplasms / surgery

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(PMID = 16967359.001).

[ISSN] 0028-3843

[Journal-full-title] Neurologia i neurochirurgia polska

[ISO-abbreviation] Neurol. Neurochir. Pol.

[Language] pol

[Publication-type] Case Reports; English Abstract; Journal Article

[Publication-country] Poland

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The long-term efficacy of conventional radiotherapy in patients with GH-secreting pituitary adenomas.

OBJECTIVE: To assess the long-term efficacy and safety of conventional radiotherapy (RT) in the control of acromegaly according to recent stringent criteria of cure.

PATIENTS AND METHODS: Forty-seven patients with active acromegaly were treated with conventional RT between 1982 and 1994.

All patients were first operated on and successively irradiated at a dose of 45-50 Gy in 25-28 fractions for persistent (n = 40) or recurrent (n = 7) disease.

MEASUREMENTS: Long-term GH/IGF-I secretion and local tumour control were evaluated regularly, and possible side-effects were searched for systematically, especially in terms of secondary endocrine dysfunction.

Biochemical cure of acromegaly was defined by glucose-suppressed plasma GH levels below 1 microg/l during an oral glucose tolerance test (OGTT) and normal age-corrected IGF-I values.

Suppression of GH during OGTT was seen in 9% of patients at 2 years, 29% at 5 years, 52% at 10 years, and 77% at 15 years.

Normalization of GH/IGF-I mainly depended on pre-RT levels.

CONCLUSION: Conventional RT is effective in the long-term control of GH-secreting pituitary adenomas, although with a high prevalence of progressive hypopituitarism.

[MeSH-major] Acromegaly / radiotherapy. Adenoma / radiotherapy. Adenoma / secretion. Growth Hormone / secretion. Pituitary Neoplasms / radiotherapy. Pituitary Neoplasms / secretion

[MeSH-minor] Adult. Female. Follow-Up Studies. Glucose Tolerance Test. Humans. Insulin-Like Growth Factor I / analysis. Male. Middle Aged. Retrospective Studies. Survival Rate. Treatment Outcome

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(PMID = 15670198.001).

[ISSN] 0300-0664

[Journal-full-title] Clinical endocrinology

[ISO-abbreviation] Clin. Endocrinol. (Oxf)

[Language] eng

[Publication-type] Journal Article

[Publication-country] England

[Chemical-registry-number] 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Intra-sellar schwannoma co-existing with GH-secreting pituitary adenoma.

BACKGROUND: We present a unique example of an intra-sellar schwannoma co-existing with a growth hormone (GH)-secreting pituitary adenoma.

METHOD AND FINDINGS: The patient presented with acromegaly and magnetic resonance imaging (MRI) revealed an intra-sellar mass.

Histopathology demonstrated the presence of a GH-secreting adenoma as well as a schwannoma at the periphery of the adenoma.

After surgical excision, remission of the acromegaly occurred.

Follow-up monitoring showed no evidence of recurrence of the adenoma two years after surgery.

CONCLUSION: To the best of our knowledge, this is the first example of an intra-sellar schwannoma co-existing with a GH-secreting pituitary adenoma.

[MeSH-major] Adenoma / pathology. Neoplasms, Multiple Primary / pathology. Neurilemmoma / pathology. Pituitary Neoplasms / pathology. Sella Turcica / pathology

[MeSH-minor] Adult. Humans. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery

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(PMID = 19350200.001).

[ISSN] 0942-0940

[Journal-full-title] Acta neurochirurgica

[ISO-abbreviation] Acta Neurochir (Wien)

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Austria

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The evaluation of ghrelin mRNA expression in human somatotroph adenomas.

Ghrelin is one of the peptides involved into GH-release, binding to specific GHS receptors on hypothalamus and pituitary.

The ghrelin peptide and ghrelin mRNA have been detected in several regions of hypothalamus, in normal pituitary, as well as in various types of pituitary adenoma, with different levels of expression in different tumour types.

We decided to determine the expression of ghrelin in somatotroph adenomas.

Human pituitary somatotroph adenoma tissues were obtained at the time of transsphenoidal surgery from 3 acromegalic patients and studied for ghrelin mRNA expression.

We wished to determine the number of copies of ghrelin gene within the single cell.

[MeSH-major] Adenoma / metabolism. Human Growth Hormone / metabolism. Peptide Hormones / biosynthesis. Pituitary Neoplasms / metabolism

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(PMID = 16648773.001).

[ISSN] 0172-780X

[Journal-full-title] Neuro endocrinology letters

[ISO-abbreviation] Neuro Endocrinol. Lett.

[Language] eng

[Publication-type] Journal Article

[Publication-country] Sweden

[Chemical-registry-number] 0 / Actins; 0 / DNA, Complementary; 0 / Ghrelin; 0 / Peptide Hormones; 0 / RNA, Messenger; 12629-01-5 / Human Growth Hormone; EC 1.2.1.- / Glyceraldehyde-3-Phosphate Dehydrogenases

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

A 28-year-old male presented to the Orthodontic clinic for correction of his anterior crossbite due to mandibular prognathism as a result of pituitary adenoma with acromegaly.

We discuss the radiographic diagnosis of an enlarged sella turcica in intrasellar tumours and also emphasise the dentist's important role in the initial diagnosis of pituitary adenoma cases.

[MeSH-major] Acromegaly / radiography. Cephalometry. Sella Turcica / radiography

[MeSH-minor] Adenoma / complications. Adult. Humans. Male. Malocclusion, Angle Class III / etiology. Malocclusion, Angle Class III / radiography. Patient Care Planning. Pituitary Neoplasms / complications. Prognathism / etiology. Prognathism / radiography. Radiographic Magnification. Radiography, Panoramic

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(PMID = 16120882.001).

[ISSN] 0250-832X

[Journal-full-title] Dento maxillo facial radiology

[ISO-abbreviation] Dentomaxillofac Radiol

[Language] eng

[Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] England

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Efficacy of chimeric molecules directed towards multiple somatostatin and dopamine receptors on inhibition of GH and prolactin secretion from GH-secreting pituitary adenomas classified as partially responsive to somatostatin analog therapy.

OBJECTIVE: This study compared the potency of a somatostatin receptor (sstr)2-sstr5 analog, BIM-23244, of an sstr2-dopamine D2 receptor (sstr2-DAD2) molecule, BIM-23A387 and of new somatostatin-dopamine chimeric molecules with differing, enhanced affinities for sstr2, sstr5 and DAD2, BIM-23A758, BIM-23A760 and BIM-23A761, to suppress GH and prolactin (PRL) from 18 human GH adenomas that are partially responsive to octreotide or lanreotide.

The effect of drugs was tested in cell cultures at various concentrations.

In 13 tumors, the maximal suppression of GH secretion produced by BIM-23A387 (30+/-3%) and BIM-23244 (28+/-3%) was greater than that produced by octreotide (23+/-3%).

In six out of 13 tumors, BIM-23A758, BIM-23A760 and BIM- 23A761 produced greater maximal suppression of GH secretion than octreotide (33+/-5, 38+/-2 and 41+/-2 vs 24+/-2%).

BIM-23A761 was more effective than BIM-23A387 in GH suppression (41+/-2 vs 32+/-4%).

CONCLUSIONS: Novel dopamine-somatostatin chimeric molecules with differing, enhanced activity at sstr2, sstr5 and DAD2, consistently produced significatly greater suppression of GH and PRL than either octreotide or single-receptor-interacting ligands in tumors from patients classified as only partially responsive to octreotide therapy.

The other mechanisms by which such molecules produce an enhanced inhibition of GH remain to be elucidated.

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(PMID = 15994755.001).

[ISSN] 0804-4643

[Journal-full-title] European journal of endocrinology

[ISO-abbreviation] Eur. J. Endocrinol.

[Language] ENG

[Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] England

[Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / BIM 23A760; 0 / BIM-23244; 0 / BIM-23A761; 0 / RNA, Messenger; 0 / Receptors, Dopamine D2; 0 / Receptors, Somatostatin; 0 / Recombinant Fusion Proteins; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; 9002-62-4 / Prolactin; RWM8CCW8GP / Octreotide; VTD58H1Z2X / Dopamine

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The implication of somatotroph adenoma phenotype to somatostatin analog responsiveness in acromegaly.

CONTEXT: Persistently elevated GH and IGF-I levels are associated with increased mortality.

OBJECTIVE: The objective of this study was to examine the significance of somatotroph adenoma type on response to SSA.

PATIENTS: Forty patients with acromegaly were studied.

MAIN OUTCOME MEASURES: Normalization of IGF-I levels and GH responses were the main outcome measures.

RESULTS: Univariate analysis revealed that responders were more likely to have densely granulated somatotroph adenomas (80% vs. 43.8%; P = 0.024), to be older (51.3 vs. 38.2 yr; P < 0.003), to have smaller tumors (stage < or =3; 78.6% vs. 35.7%; P = 0.022), to have lower baseline IGF-I (453 vs. 716 microg/liter; P < 0.001) and GH levels (2.7 vs. 7.8 microg/liter; P < 0.05), and to require a lower maximum dose of SSA (24 vs. 31 mg every 4 wk; P = 0.013).

Multivariate analysis confirmed that a densely granulated adenoma was the strongest predictor of complete response [adjusted odds ratio (OR), 58.41; 95% confidence interval (CI), 1.24-1000.00; P = 0.04] compared with other covariates, including older age at time of diagnosis (OR, 1.15/yr; 95% CI, 1.01-1.31; P = 0.03), and tumor stage of 3 or less (OR, 29.77; 95% CI, 1.01-885.45; P < 0.05).

CONCLUSIONS: Somatotroph tumor type represents a strong clinical predictor of response to SSA treatment and will help to identify patients who warrant more vigilant management of their disease.

[MeSH-major] Acromegaly / drug therapy. Adenoma / drug therapy. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy

[MeSH-minor] Adult. Aged. Female. Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / analysis. Male. Middle Aged. Multivariate Analysis. Phenotype. Retrospective Studies

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(PMID = 16118335.001).

[ISSN] 0021-972X

[Journal-full-title] The Journal of clinical endocrinology and metabolism

[ISO-abbreviation] J. Clin. Endocrinol. Metab.

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

[Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; RWM8CCW8GP / Octreotide

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Short-term preoperative octreotide treatment of GH-secreting pituitary adenoma: predictors of tumor shrinkage.

We reviewed the cases of 32 patients with growth hormone (GH)-secreting macroadenoma who underwent short-term octreotide treatment before transsphenoidal surgery to determine which types of adenoma the preoperative treatment were sensitive and whether predictors of tumor shrinkage could be identified.

At a daily dose of 300 microg for 2-3 weeks, octreotide reduced serum GH and insulin-like growth factor-1 (IGF-1) levels to 31.9 % and 51.6% of pretreatment values, respectively, and led to a mean tumor volume of 68% of pretreatment volume in 52% of the patients.

Preoperative short-term octreotide treatment is effective for GH-secreting macroadeomas of Knosp grades 1-2 and a good response to both octreotide and bromocriptine challenge tests is a predictor of subsequent tumor shrinkage.

[MeSH-major] Antineoplastic Agents, Hormonal / therapeutic use. Growth Hormone-Secreting Pituitary Adenoma / drug therapy. Growth Hormone-Secreting Pituitary Adenoma / pathology. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / pathology

[MeSH-minor] Acromegaly / etiology. Adult. Aged. Combined Modality Therapy. Dose-Response Relationship, Drug. Female. Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / analysis. Magnetic Resonance Imaging. Male. Middle Aged. Patient Selection. Predictive Value of Tests. Preoperative Care / methods. Time Factors. Tumor Burden / drug effects

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(PMID = 16543682.001).

[ISSN] 0918-8959

[Journal-full-title] Endocrine journal

[ISO-abbreviation] Endocr. J.

[Language] eng

[Publication-type] Clinical Trial; Journal Article

[Publication-country] Japan

[Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone; RWM8CCW8GP / Octreotide

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] MRI finding of simultaneous coexistence of growth hormone-secreting pituitary adenoma with intracranial meningioma and carotid artery aneurysms: report of a case.

Coexistence of pituitary adenoma, intracranial meningioma and cerebral aneurysm has never been described.

We report on a patient with GH-secreting pituitary macroadenoma associated with a right frontal meningioma and with two intracavernous asymptomatic aneurisms.

A 61-year-old woman was referred to our Endocrine Unit 13 years after a right frontal craniotomy for a pituitary tumour.

Endocrine investigation showed high levels of IGF-1 (560 ng/ml) and increased basal serum GH (56 ng/ml) levels, not suppressed after OGTT.

MRI showed persistence of a homogeneously enhancing intra- and suprasellar lesion, compressing the visual pathways, with bilateral intracavernous invasion and simultaneous coexistence of a right intracavernous internal carotid artery (ICA) aneurysm in direct contact with the pituitary tumour.

Somatostatin analog treatment normalized GH and IGF-1 levels.

One year later, a new MRI confirmed the presence of the pituitary mass showing also a right intracranial frontal meningioma and a new ICA aneurysm on the left side.

Previous studies have suggested that prolonged GH hypersecretion could play a role in the genesis of intracranial aneurysms, inducing atherosclerotic and/or degenerative modification of the arterial walls.

Other aetiological factors include a mechanical effect due to a direct contact between adenoma and aneurysm.

Coexistence of pituitary adenoma and intracranial meningioma is a rare event, but also for this association it has been suggested that GH or other growth factors could play a role in appearance or in growth of meningioma.

In our case, meningioma appeared and grew, despite the effective treatment of acromegaly.

[MeSH-major] Carotid Artery Diseases / complications. Carotid Artery Diseases / diagnosis. Growth Hormone-Secreting Pituitary Adenoma / complications. Growth Hormone-Secreting Pituitary Adenoma / diagnosis. Intracranial Aneurysm / complications. Intracranial Aneurysm / diagnosis. Meningioma / complications. Meningioma / diagnosis. Pituitary Neoplasms / complications. Pituitary Neoplasms / diagnosis

[MeSH-minor] Cerebral Angiography. Female. Hormones / blood. Human Growth Hormone / secretion. Humans. Magnetic Resonance Angiography. Magnetic Resonance Imaging. Middle Aged. Neurosurgical Procedures

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(PMID = 17334927.001).

[ISSN] 1386-341X

[Journal-full-title] Pituitary

[ISO-abbreviation] Pituitary

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] United States

[Chemical-registry-number] 0 / Hormones; 12629-01-5 / Human Growth Hormone

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] BIM-23A760, a chimeric molecule directed towards somatostatin and dopamine receptors, vs universal somatostatin receptors ligands in GH-secreting pituitary adenomas partial responders to octreotide.

We report the comparative efficacy of a somatostatin receptor 1 and 5 subtypes (SSTR2 and SSTR5), and dopamine D2 (DAD2) compound, BIM-23A760, in suppressing GH secretion, in cell culture from human GH-secreting tumors, from patients partially responsive to long-term treatments with octreotide or lanreotide.

The SSTR2-selective analog, BIM-23197, the SSTR5-selective analog, BIM-23268, and the dopamine (DA) analog, BIM-53097, produced a mean maximal suppression of GH secretion (24 +/- 3, 20 +/- 3, and 20 +/- 3%, respectively) that was similar to that obtained with octreotide (23 +/- 3%).

Among a series of new chimeric compounds that bind the SSTR2, SSTR5, and DAD2 receptors with variable affinities, BIM-23A760 produced greater maximal suppression of GH secretion than octreotide (38 +/- 2 vs 24 +/- 2%; p<0.03).

In the presence of sulpride, the dose response inhibition of GH secretion by the trihybrid molecule, BIM-23A760, was partially reversed.

When SSTRs pan inhibitors such as BIM-23A779 (binding affinity for SSTR1, SSTR2, SSTR3, SSTR5, respectively: 2.5, 0.3, 0.6, 0.6 nmol/l) or SOM230 were tested for their suppressive effects on GH secretion, they were less potent than the previous dopastatin hybrid molecule.

After a brief exposure to a SSTR2-selective analog, BIM-23197, or to a DA analog, BIM-53097, the maximal GH suppression was achieved during 12 h.

Under exposure to BIM-23A760, in the same conditions, maximal suppression of GH secretion lasted for 24 h.

As compared to the dopastatin compound, the lower efficacy of the universal somatostatin ligands in the inhibition of GH secretion of GH-secreting tumors argues for the use of drugs targeted, according to specific receptors expression and functionality which may vary among the various classes of tumors.

[MeSH-major] Human Growth Hormone / secretion. Octreotide / therapeutic use. Pituitary Neoplasms / drug therapy. Pituitary Neoplasms / secretion. Receptors, Dopamine / metabolism. Receptors, Somatostatin / metabolism

[MeSH-minor] Acromegaly / drug therapy. Adult. Female. Gene Expression. Humans. Male. Oligopeptides / pharmacology. Piperazines / pharmacology. Prolactin / secretion. RNA, Messenger / analysis. Receptors, Dopamine D2 / genetics

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(PMID = 16625841.001).

[ISSN] 0391-4097

[Journal-full-title] Journal of endocrinological investigation

[ISO-abbreviation] J. Endocrinol. Invest.

[Language] eng

[Publication-type] Journal Article

[Publication-country] Italy

[Chemical-registry-number] 0 / BIM 23197; 0 / Oligopeptides; 0 / Piperazines; 0 / RNA, Messenger; 0 / Receptors, Dopamine; 0 / Receptors, Dopamine D2; 0 / Receptors, Somatostatin; 0 / somatostatin receptor 2; 0 / somatostatin receptor 5; 12629-01-5 / Human Growth Hormone; 9002-62-4 / Prolactin; RWM8CCW8GP / Octreotide

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The role of stereotactic radiosurgery in the multimodal management of growth hormone-secreting pituitary adenomas.

Growth hormone (GH)-secreting pituitary adenomas represent a common source of GH excess in patients with acromegaly.

Whereas surgical extirpation of the culprit lesion is considered first-line treatment, as many as 19% of patients develop recurrent symptoms due to regrowth of previously resected adenomatous tissue or to continued growth of the surgically inaccessible tumor.

Although medical therapies that suppress GH production can be effective in the management of primary and recurrent acromegaly, these therapies are not curative, and lifelong treatment is required for hormonal control.

The authors reviewed the growing body of literature concerning the role of radiosurgical procedures in the treatment armamentarium of acromegaly, and identified more than 1350 patients across 45 case series.

In this review, the authors report that radiosurgery offers true hormonal normalization in 17% to 82% of patients and tumor growth control in 37% to 100% of cases across all series, while minimizing adverse complications.

As a result, stereotactic radiosurgery represents a safe and effective treatment option in the multimodal management of primary or recurrent acromegaly secondary to GH-secreting pituitary adenomas.

[MeSH-major] Acromegaly / surgery. Adenoma / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. Radiosurgery / methods. Radiotherapy, Adjuvant / methods

[MeSH-minor] Combined Modality Therapy. Human Growth Hormone / antagonists & inhibitors. Human Growth Hormone / secretion. Humans. Pituitary Neoplasms / blood. Pituitary Neoplasms / radiotherapy. Pituitary Neoplasms / surgery. Treatment Outcome. Tumor Burden

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(PMID = 20887121.001).

[ISSN] 1092-0684

[Journal-full-title] Neurosurgical focus

[ISO-abbreviation] Neurosurg Focus

[Language] eng

[Publication-type] Comparative Study; Journal Article; Review

[Publication-country] United States

[Chemical-registry-number] 12629-01-5 / Human Growth Hormone

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Transient MR changes and symptomatic epilepsy following gamma knife treatment of a residual GH-secreting pituitary adenoma in the cavernous sinus.

OBJECTIVE: To report a rare side effect of gamma knife treatment of pituitary macroadenoma.

CASE REPORT: In a forty-one-year old female patient acromegaly was diagnosed due to a growth hormone secreting pituitary macroadenoma.

Following transsphenoidal surgery the patient underwent gamma knife treatment for persistent uncontrolled acromegaly activity of residual tumor, infiltrating the left cavernous sinus.

CONCLUSION: Gamma knife surgery of a pituitary adenoma may cause radiation induced MR changes of the mesial temporal lobe mimicking glioma or radionecrosis and cause symptomatic epileptic seizures.

[MeSH-major] Adenoma / surgery. Brain Injuries / etiology. Epilepsy / etiology. Growth Hormone-Secreting Pituitary Adenoma / surgery. Radiation Injuries / etiology. Radiosurgery / adverse effects

[MeSH-minor] Acromegaly / etiology. Acromegaly / surgery. Adult. Cavernous Sinus / pathology. Cavernous Sinus / physiopathology. Cavernous Sinus / surgery. Female. Humans. Magnetic Resonance Imaging. Necrosis / diagnosis. Necrosis / etiology. Necrosis / physiopathology. Neoplasm Recurrence, Local / surgery. Pituitary Gland / pathology. Pituitary Gland / physiopathology. Pituitary Gland / surgery. Positron-Emission Tomography. Postoperative Complications / diagnosis. Postoperative Complications / etiology. Postoperative Complications / physiopathology. Temporal Lobe / pathology. Temporal Lobe / radiation effects. Temporal Lobe / radionuclide imaging

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(PMID = 16761113.001).

[ISSN] 0001-6268

[Journal-full-title] Acta neurochirurgica

[ISO-abbreviation] Acta Neurochir (Wien)

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Austria

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Acromegaly pathogenesis and treatment.

Dysregulated growth hormone (GH) hypersecretion is usually caused by a GH-secreting pituitary adenoma and leads to acromegaly - a disorder of disproportionate skeletal, tissue, and organ growth.

High GH and IGF1 levels lead to comorbidities including arthritis, facial changes, prognathism, and glucose intolerance.

This Review discusses acromegaly pathogenesis and management options.

Somatostatin receptor (SSTR) ligands inhibit GH release, control tumor growth, and attenuate peripheral GH action, while GH receptor antagonists block GH action and effectively lower IGF1 levels.

Effective control of GH and IGF1 hypersecretion and ablation or stabilization of the pituitary tumor mass lead to improved comorbidities and lowering of mortality rates for this hormonal disorder.

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(PMID = 19884662.001).

[ISSN] 1558-8238

[Journal-full-title] The Journal of clinical investigation

[ISO-abbreviation] J. Clin. Invest.

[Language] ENG

[Grant] United States / NCI NIH HHS / CA / R01 CA075979; United States / NCI NIH HHS / CA / CA 075979

[Publication-type] Journal Article; Research Support, N.I.H., Extramural; Review

[Publication-country] United States

[Chemical-registry-number] 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone

[Number-of-references] 125

[Other-IDs] NLM/ PMC2769196

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] The role of stereotactic radiotherapy in patients with growth hormone-secreting pituitary adenoma.

CONTEXT: Single-session stereotactic radiotherapy (SR) may be a potential adjuvant treatment in acromegaly.

INTERVENTION: The patients were treated with SR for residual or recurrent GH-secreting adenoma.

MAIN OUTCOME MEASURE: Normalization of age- and sex-adjusted IGF-I levels together with a basal GH level below 2.5 microg/liter without concomitant GH-suppressive drugs was the goal of therapy.

Multivariate analysis showed that low basal GH and IGF-I levels were associated with a favorable outcome.

This may lead to reconsider the role of SR in the therapeutic algorithm of acromegaly.

[MeSH-major] Adenoma / surgery. Growth Hormone-Secreting Pituitary Adenoma / surgery. Radiosurgery

[MeSH-minor] Adult. Female. Human Growth Hormone / blood. Humans. Insulin-Like Growth Factor I / analysis. Male. Retrospective Studies

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[CommentIn] Nat Clin Pract Endocrinol Metab. 2008 Nov;4(11):592-3 [18762791.001]

(PMID = 18413424.001).

[ISSN] 0021-972X

[Journal-full-title] The Journal of clinical endocrinology and metabolism

[ISO-abbreviation] J. Clin. Endocrinol. Metab.

[Language] eng

[Publication-type] Journal Article

[Publication-country] United States

[Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Expression of pituitary tumour-derived, N-terminally truncated isoform of fibroblast growth factor receptor 4 (ptd-FGFR4) correlates with tumour invasiveness but not with G-protein alpha subunit (gsp) mutation in human GH-secreting pituitary adenomas.

OBJECTIVE: Apart from the constitutively activating mutation of the G-protein alpha subunit (Gsalpha) (gsp mutation), factors involved in tumorigenesis or those in tumour behaviour remain elusive in sporadic GH-secreting pituitary adenomas.

Recently, the N-terminally truncated form of fibroblast growth factor receptor-4 (ptd-FGFR4) was identified in pituitary adenomas.

This aberrant receptor has transforming activity, and causes pituitary adenomas in transgenic mice.

MATERIALS AND METHODS: mRNA was extracted from excised adenomas of 45 Japanese acromegalic patients. ptd-FGFR4 expression and gsp mutations were determined by reverse transcription polymerase chain reaction (RT-PCR) and direct sequencing.

Preoperative clinical data were collected by reviewing medical charts and pituitary magnetic resonance imaging (MRI) scans.

The presence of ptd-FGFR4 did not correlate with age at operation, sex, preoperative serum GH or IGF-1 levels.

CONCLUSIONS: We found that ptd-FGFR4 expression and gsp mutations occur independently of each other, and that ptd-FGFR4 expression is associated with more invasive tumours in patients with GH-secreting pituitary adenomas.

[MeSH-major] GTP-Binding Protein alpha Subunits / genetics. Gene Expression. Growth Hormone-Secreting Pituitary Adenoma / genetics. Mutation. Neoplasm Invasiveness. Pituitary Neoplasms / genetics. Receptor, Fibroblast Growth Factor, Type 4 / genetics

MedlinePlus Health Information. consumer health - Pituitary Tumors.

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(PMID = 18070145.001).

[ISSN] 1365-2265

[Journal-full-title] Clinical endocrinology

[ISO-abbreviation] Clin. Endocrinol. (Oxf)

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] England

[Chemical-registry-number] 0 / GTP-Binding Protein alpha Subunits; 0 / Protein Isoforms; EC 2.7.10.1 / Receptor, Fibroblast Growth Factor, Type 4

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [New medical treatments in pituitary adenomas].

Currently, the role of dopaminergic and somatostatinergic agonists in the treatment of pituitary adenomas is quite well established.

Nevertheless, a clearer understanding of the expression of dopaminergic and somatostatinergic receptors at the cellular level of pituitary adenomas as well as the development of newer analogues compounds may drastically change current therapeutic modalities.

In the midst of GH-secreting pituitary adenomas, a positive correlation exists between the expression of Sst2 mRNA and the inhibition of GH release by somatostatin analogues.

The involvement of Sst5 subtype in adenomas resistant to preferential Sst2 agonists has recently been proved.

SOM-230 could therefore allow for much more effective methods in treating patients suffering from acromegaly.

Besides, the use of a chimeric molecule presenting a binding affinity to both Sst2 and D2 subtypes (BIM-23A287) inhibits the secretion of GH in ways similar to the Sst2 or D2 agonists used alone or concurrently but however in a concentration 50 times lower than that of the latter.

The discovery of Sst5 and D2 subtypes at the level of corticotropic adenomas reveals newer therapeutic perspectives with promising preliminary results with the use of SOM-230 ; these finding lead to a rise in interest in cabergoline.

In the midst of non-functioning pituitary adenomas, the expression of Sst2, Sst3 and D2 receptors will perhaps allow the use of combined therapies associating the new somatostatin analogues to the dopaminergic agonists or even use dopastatin (BIM-23A760, chimeric molecule Sst2-Sst5-D2).

Nevertheless, it seems that adenomas resistant to dopaminergic agonist due to a lack of expression of D2 receptor fail to express Sst5 receptors as well.

On the other hand, dopastatin appears to be more efficient than cabergoline in the management of this type of adenomas.

Therefore, the growing awareness concerning the mechanisms involved in the control of pituitary secretions as well as cellular proliferation will perhaps allow physicians to treat the pathology of pituitary adenomas, macroadenomas in particular, using solely pharmacological means instead of invasive surgical procedures and/or radiotherapy.

[MeSH-major] Adenoma / drug therapy. Pituitary Neoplasms / drug therapy

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(PMID = 18954854.001).

[ISSN] 0003-4266

[Journal-full-title] Annales d'endocrinologie

[ISO-abbreviation] Ann. Endocrinol. (Paris)

[Language] fre

[Publication-type] English Abstract; Journal Article; Review

[Publication-country] France

[Chemical-registry-number] 0 / Dopamine Agonists; 0 / Peptides, Cyclic; 0 / Receptors, Dopamine; 0 / Receptors, Somatostatin; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin; RWM8CCW8GP / Octreotide

[Number-of-references] 49

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Effect of preoperative use of long-acting octreotide on growth hormone secreting pituitary adenoma and transsphenoidal surgery.

OBJECTIVE: To investigate whether somatostatin analog octreotide long acting release (LAR) shrinks growth hormone (GH) secreting adenomas, and improves the results of subsequent transsphenoidal surgery.

METHODS: Seventeen previously untreated active acromegalic patients with pituitary adenomas were treated with LAR (30 mg intramuscular injection every 28 days) for 3 months prior to transsphenoidal surgery.

Clinical reaction, mean GH secretion, and tumor volume were measured under basal conditions and after LAR treatment.

RESULTS: Presurgical treatment improved acromegaly symptoms and induced a significant reduction of GH under the 5 ng/mL limit in microadenoma (P < 0.05), while only 18.2% (2/11) in macroadenoma.

During operation, adenoma was soft in 15 cases, with the exception of 2 cases in which the soft tumor was divided by fibrous septa, but all tumor removal was smooth.

CONCLUSIONS: A short term administration of preoperative LAR may induce a significant decrease in GH-secretion level and adenoma volume.

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(PMID = 15844307.001).

[ISSN] 1001-9294

[Journal-full-title] Chinese medical sciences journal = Chung-kuo i hsueh k'o hsueh tsa chih

[ISO-abbreviation] Chin. Med. Sci. J.

[Language] ENG

[Publication-type] Journal Article

[Publication-country] China

[Chemical-registry-number] 0 / Antineoplastic Agents, Hormonal; 0 / Delayed-Action Preparations; 12629-01-5 / Human Growth Hormone; RWM8CCW8GP / Octreotide

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Elevation of growth hormone secretagogue receptor type 1a mRNA expression in human growth hormone-secreting pituitary adenoma harboring G protein alpha subunit mutation.

OBJECTIVE: The purpose of this study was to investigate the relationship between the ghrelin or GHSR-1a mRNA levels and clinical characteristics and to confirm the effect of gsp mutations on ghrelin/GHSR-1a system in human GH-secreting pituitary adenomas.

The gsp mutations in 43 cases of human GH-secreting pituitary adenomas were detected using PCR-DNA direct sequencing analysis.

Clinical data were obtained from the medical records of 43 acromegalic patients who had GH and IGF-1 assays in the same laboratory.

The expression level of GHSR-1a mRNA was significantly higher in gsp positive adenomas than in negative adenomas (p<0.05).

Whereas, there was no significant difference in the expression of ghrelin mRNA between gsp mutation-positive and -negative adenomas (p>0.05).

Additionally there was a significant positve correlation between the ghrelin and GHSR-1a mRNA expression levels in gsp-positive (R=0.553, p=0.040) or -negative adenomas (R=0.489, p=0.007).

Gsp mutations may upregulate the expression of GHSR-1a mRNA and have no effect on ghrelin mRNA levels in human GH-secreting pituitary adenomas.

[MeSH-major] Adenoma / genetics. GTP-Binding Protein alpha Subunits / genetics. Growth Hormone-Secreting Pituitary Adenoma / genetics. Mutation. Receptors, Ghrelin / genetics

[MeSH-minor] Acromegaly / etiology. Acromegaly / genetics. Adult. Female. Ghrelin / genetics. Ghrelin / metabolism. Humans. Male. Middle Aged. RNA, Messenger / metabolism. Retrospective Studies. Tumor Burden. Up-Regulation. Young Adult

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(PMID = 20150876.001).

[ISSN] 0172-780X

[Journal-full-title] Neuro endocrinology letters

[ISO-abbreviation] Neuro Endocrinol. Lett.

[Language] eng

[Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] Sweden

[Chemical-registry-number] 0 / GTP-Binding Protein alpha Subunits; 0 / Ghrelin; 0 / RNA, Messenger; 0 / Receptors, Ghrelin

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

OBJECTIVE: Our objective was to evaluate the role of CDKN1B/p27(Kip1) in human tumor predisposition in patients clinically suspected of MEN1 but testing negative for MEN1 germline mutation as well as in familial and sporadic acromegaly/pituitary adenoma patients.

In addition, 19 familial and 50 sporadic acromegaly/pituitary adenoma patients from Europe and the United States were included in the study.

MAIN OUTCOME MEASURES: We analyzed germline CDKN1B/p27(Kip1) mutations in individuals with pituitary adenoma and MEN1-like features.

RESULTS: A heterozygous 19-bp duplication (c.59_77dup19) leading to a truncated protein product was identified in one Dutch patient with suspected MEN1 phenotype, pituitary adenoma, carcinoid tumor, and hyperparathyroidism (one of 36, 2.8%).

No mutations were detected in either familial or sporadic acromegaly/pituitary adenoma patients.

CONCLUSIONS: Our results support the previous finding that germline CDKN1B/p27(Kip1) mutations predispose to a human MEN1-like condition.

However, such mutations appear uncommon in suspected MEN1 cases and rare or nonexistent in familial or sporadic acromegaly/pituitary adenoma patients.

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(PMID = 17519308.001).

[ISSN] 0021-972X

[Journal-full-title] The Journal of clinical endocrinology and metabolism

[ISO-abbreviation] J. Clin. Endocrinol. Metab.

[Language] eng

[Databank-accession-numbers] GENBANK/ EF474465

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] United States

[Chemical-registry-number] 0 / CDKN1B protein, human; 0 / Intracellular Signaling Peptides and Proteins; 147604-94-2 / Cyclin-Dependent Kinase Inhibitor p27; 9007-49-2 / DNA

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Acromegaly due to a somatroph adenoma in a dog.

The basal serum growth hormone (GH) concentration was markedly elevated (23microg/l) and did not decrease during a glucose tolerance test or after somatostatin administration.

The serum insulin-like growth factor-1 concentration was also markedly elevated (1254microg/l).

CT scanning of the skull showed an enlarged pituitary gland with normal enhancement pattern.

The pituitary gland contained an acidophilic adenoma that immunostained positively for GH (and negatively for ACTH and alpha-MSH).

In conclusion, this Dalmatian dog with acromegaly and insulin resistance represents the first case of GH hypersecretion proven to be due to a somatotroph adenoma.

[MeSH-major] Acromegaly / veterinary. Adenoma / veterinary. Dog Diseases / pathology. Pituitary Neoplasms / veterinary

[MeSH-minor] Animals. Dogs. Fatal Outcome. Growth Hormone / blood. Insulin Resistance. Male. Spinal Osteophytosis / complications. Spinal Osteophytosis / pathology. Spinal Osteophytosis / veterinary

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(PMID = 16472961.001).

[ISSN] 0739-7240

[Journal-full-title] Domestic animal endocrinology

[ISO-abbreviation] Domest. Anim. Endocrinol.

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] United States

[Chemical-registry-number] 9002-72-6 / Growth Hormone

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Craniopharyngioma in a patient with acromegaly due to a pituitary macroadenoma.

We present the first reported case of a craniopharyngioma as a second primary tumor in a patient with acromegaly due to a growth hormone (GH)-secreting pituitary adenoma.

The patient was lost for follow-up for 18 years after trans-sphenoidal pituitary surgery for a GH-secreting pituitary adenoma.

She presented with headaches and decreased visual acuity, and showed unsuppressed GH in an oral glucose load test with high IGF-1 levels.

Biopsy of the mass confirmed the diagnosis of a craniopharyngioma.

We stress the need for close follow-up of patients with acromegaly with adequate control of GH and IGF-1 levels.

[MeSH-major] Acromegaly / etiology. Adenoma / pathology. Craniopharyngioma / pathology. Growth Hormone / secretion. Neoplasms, Second Primary / pathology. Pituitary Neoplasms / pathology

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[Cites] Am J Med. 1978 May;64(5):874-82 [206142.001]

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(PMID = 20864785.001).

[ISSN] 0975-4466

[Journal-full-title] Annals of Saudi medicine

[ISO-abbreviation] Ann Saudi Med

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Saudi Arabia

[Chemical-registry-number] 9002-72-6 / Growth Hormone

[Other-IDs] NLM/ PMC2994169

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Diagnostic value of 18F-dihydroxyphenylalanine positron emission tomography for growth hormone-producing pituitary adenoma.

A 55-year-old woman with signs of acromegaly was referred to our hospital.

Endocrinological examinations showed that she had high levels of growth hormone (GH; 5.54 ng ml(-1); normal range: 0.66-3.68 ng ml(-1)) and insulin-like growth factor-I (IGF-I; 508 ng ml(-1); normal range: 37-266 ng ml(-1)) levels, incomplete suppression of serum GH following a 75-gram oral glucose tolerance test (oGTT; trough GH 3.66 ng ml(-1)), and paradoxical GH responses to a TRH provocation test (peak GH 38.9 ng ml(-1)).

Dynamic magnetic resonance imaging (MRI) suggested the presence of an intrasellar mass lesion (5.9 x 2.8 mm) in the left part of her pituitary gland (Fig.

Subsequent histological analysis confirmed the diagnosis of a GH-producing pituitary adenoma.

After removal, serum IGF-I levels decreased to a normal range (178 ng ml(-1)), and serum GH was appropriately suppressed during oGTT (trough GH 0.30 ng ml(-1)), suggesting that complete resection was obtained [1].

PET scans are reported to be a valuable tool for the detection of pituitary adenomas [2-4].

This case clearly showed that FDG-PET is also useful for re-evaluation of the disease after surgery.

PET scans are recommended for patients with equivocal pituitary mass lesions on conventional MRI, and for follow-up examinations after surgery.

[MeSH-major] Dihydroxyphenylalanine. Fluorine Radioisotopes. Growth Hormone-Secreting Pituitary Adenoma / diagnosis. Positron-Emission Tomography / methods

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[Cites] Eur J Nucl Med Mol Imaging. 2006 Feb;33(2):169-78 [16228237.001]

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(PMID = 19915981.001).

[ISSN] 1573-7403

[Journal-full-title] Pituitary

[ISO-abbreviation] Pituitary

[Language] eng

[Publication-type] Case Reports; Evaluation Studies; Journal Article

[Publication-country] United States

[Chemical-registry-number] 0 / Fluorine Radioisotopes; 63-84-3 / Dihydroxyphenylalanine

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Outcomes after a purely endoscopic transsphenoidal resection of growth hormone-secreting pituitary adenomas.

OBJECT: Using strict biochemical remission criteria, the authors assessed surgical outcomes after endoscopic transsphenoidal resection of growth hormone (GH)-secreting pituitary adenomas and identified preoperative factors that significantly influence the rate of remission.

The authors reviewed cases in which an endoscopic resection of GH-secreting pituitary adenomas was performed.

The thresholds of an age-appropriate, normalized insulin-like growth factor-I concentration, a nadir GH level after oral glucose load of less than 1.0 μg/l, and a random GH value of less than 2.5 μg/l were required to establish biochemical cure postoperatively.

RESULTS: Overall, in 57.7% of patients undergoing a purely endoscopic transsphenoidal pituitary adenectomy for acromegaly, an endocrinological cure was achieved.

CONCLUSIONS: A purely endoscopic transsphenoidal approach to GH-secreting pituitary adenomas leads to similar outcome for noninvasive macroadenomas compared with traditional microsurgical techniques.

Furthermore, this approach may often provide maximal visualization of the tumor, the pituitary gland, and the surrounding neurovascular structures.

[MeSH-major] Acromegaly / surgery. Endoscopy / methods. Growth Hormone-Secreting Pituitary Adenoma / surgery. Human Growth Hormone / secretion

[MeSH-minor] Adenoma / surgery. Adult. Aged. Female. Humans. Insulin-Like Growth Factor I / analysis. Longitudinal Studies. Male. Microsurgery / methods. Middle Aged. Neoplasm Invasiveness. Neurosurgical Procedures / methods. Pituitary Neoplasms / surgery. Remission Induction. Sphenoid Bone. Treatment Outcome

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(PMID = 20887130.001).

[ISSN] 1092-0684

[Journal-full-title] Neurosurgical focus

[ISO-abbreviation] Neurosurg Focus

[Language] eng

[Publication-type] Comparative Study; Journal Article

[Publication-country] United States

[Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Pituitary tumor size in acromegaly during pegvisomant treatment: experience from MR re-evaluations of the German Pegvisomant Observational Study.

In treatment-resistant patients with acromegaly, pharmacotherapy with pegvisomant (Somavert) is a highly effective option.

All three patients had undergone pituitary surgery as primary treatment, but had not been pre-treated with radiotherapy.

It was reported in between 2 and 3% of patients treated, and did not exceed the expected rate in patients with acromegaly not treated with pegvisomant.

As from this presently largest database of acromegalic patients treated with pegvisomant, tumor-growth rate appears not to be different from patients on other treatment modalities.

Although these data are reassuring with regard to the concern of somatotroph adenoma growth under peripheral GH receptor blockade, further study is required.

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(PMID = 19411302.001).

[ISSN] 1479-683X

[Journal-full-title] European journal of endocrinology

[ISO-abbreviation] Eur. J. Endocrinol.

[Language] ENG

[Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't

[Publication-country] England

[Chemical-registry-number] 0 / pegvisomant; 12629-01-5 / Human Growth Hormone

[Investigator] Droste M; Stalla GK; Allolio B; Faust M; Brendel M; Finke R; Tuchelt H; Bidlingmaier M; Engelbach M; Santen R; Hampel R; Mann K; Kann H; Boehm B; Kasperk C; Kerber C; Wallaschofski H; Moenig H; Stumvoll M; Schopohl J; Völz B; Würl K; Ittner J; Reschke K; Jacobeit J; Ramadori G; Schindler A; Zeuzem S; Badenhoop K; Beil FU; Pfeiffer AF; Vogel C; Hofbauer LC; Strasburger CJ; Tuschy U; Plöckinger U; Seidlitz B; Demtröder F; Gellner R; Gräf KJ; Schröder U; Ball P; Ventzke K; Hensen J; Lux H; Etzrodt H; Alexopoulos A; Spitzweg C; Schnabel D; Dost A; Weber MM; Wiemer K; Omran W; Keuser R; Salzgeber K; Gutekunst R; Terkamp C; Gaissmaier S; Eversmann T; Seufert J; Jaursch-Hancke C; Ritter M; Undeutsch C; Jochum E; Schleiffer T; Karges W; Meuser J; Wildbrett J; Krug J; Buchfelder M; Klingmüller D; Schmitz U; Perras B; Zick R; Leicht E; Manfras B; Schuppert F; Müller OA; Stahmer E; Kajdan U; Gallwitz; Rochlitz H; Heckmann C; Haak E; Weber R; Herrmann BL; Schneider S; Scherbaum WA; Deuss U; Jacobs B; Gerbert B; Wolf M; West T; Lippe J; Biering H

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Somatostatin receptors in GH-secreting pituitary adenomas--their relationship to the response to octreotide.

Twenty pituitary adenomas, surgically removed from patients suffering from acromegaly, were studied.

The tumours were immunostained with anti-GH and anti-PRL antibodies and with antibodies raised against particular subtypes of somatostatin receptors (rsst1-5).

In 15 patients in whom the GH response to the acute administration of 200 ug octreotide was tested the correlation between the expression of rsst and the percentage of GH drop was estimated.

All the tumours were GH-immunopositive and in the majority (14/20) co-expression of PRL was also found.

All the adenomas examined expressed rsst2A (20/20) and rsst5 (12/12) receptor proteins.

The mixed (GH/PRL) adenomas showed a tendency to a higher expression of rsst2A + + rsst2B and a greater response to octreotide administration.

A significant positive correlation was found between rsst2A + rsst2B expressions and a drop in GH after octreotide.

To conclude, the GH-inhibiting effect of octreotide depends on the intensity of expression of both rsst2A and rsst2B.

Both isoforms of rsst2 mediate the same biological response (inhibition of GH secretion) in GH-secreting and GH/PRL-secreting adenomas.

[MeSH-major] Adenoma / drug therapy. Adenoma / metabolism. Growth Hormone-Secreting Pituitary Adenoma / drug therapy. Growth Hormone-Secreting Pituitary Adenoma / metabolism. Octreotide / therapeutic use. Receptors, Somatostatin / metabolism

[MeSH-minor] Acromegaly / etiology. Antineoplastic Agents / therapeutic use. Growth Hormone / drug effects. Growth Hormone / secretion. Humans. Immunohistochemistry

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(PMID = 18615392.001).

[ISSN] 0423-104X

[Journal-full-title] Endokrynologia Polska

[ISO-abbreviation] Endokrynol Pol

[Language] eng

[Publication-type] Journal Article

[Publication-country] Poland

[Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Receptors, Somatostatin; 9002-72-6 / Growth Hormone; RWM8CCW8GP / Octreotide

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Successful treatment of acromegaly in a diabetic cat with transsphenoidal hypophysectomy.

Plasma concentrations of growth hormone (GH) (51 microg/l, reference range 0.8-7.2 microg/l) and insulin-like growth factor 1 (IGF-1) (3871 microg/l, reference range 39-590 microg/l) were highly elevated, whereas those of alpha-melanocyte-stimulating hormone, adrenocorticotropic hormone and cortisol were normal.

Computed tomography revealed a thick palatum molle and an enlarged pituitary gland, indicating a pituitary neoplasm.

Microsurgical transsphenoidal hypophysectomy was performed and microscopic examination of the surgical specimen revealed an acidophilic, infiltrative pituitary adenoma that showed positive immunostaining for GH.

One year after hypophysectomy the plasma concentrations of GH and IGF-1 were 2.4 microg/l and 113 microg/l, respectively.

PRACTICAL RELEVANCE: This is the first report detailing transsphenoidal hypophysectomy as a feasible and effective treatment for feline acromegaly due to a pituitary somatotroph adenoma.

The surgery is discussed in the context of human and other feline therapies for acromegaly.

[MeSH-major] Acromegaly / veterinary. Adenocarcinoma / veterinary. Cat Diseases / surgery. Hypophysectomy / veterinary

[MeSH-minor] Adrenocortical Hyperfunction / blood. Adrenocortical Hyperfunction / complications. Adrenocortical Hyperfunction / surgery. Adrenocortical Hyperfunction / veterinary. Animals. Blood Glucose / metabolism. Cats. Diabetes Mellitus / blood. Diabetes Mellitus / surgery. Diabetes Mellitus / veterinary. Growth Hormone / blood. Insulin-Like Growth Factor I / metabolism. Male. Sphenoid Bone. Treatment Outcome

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[Copyright] Copyright 2010 Elsevier Ltd. All rights reserved.

(PMID = 20417901.001).

[ISSN] 1532-2750

[Journal-full-title] Journal of feline medicine and surgery

[ISO-abbreviation] J. Feline Med. Surg.

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] England

[Chemical-registry-number] 0 / Blood Glucose; 67763-96-6 / Insulin-Like Growth Factor I; 9002-72-6 / Growth Hormone

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Acromegaly associated with multiple tumors.

A 56-year-old man was admitted to our hospital for the surgical removal of renal cell carcinoma (RCC).

He was diagnosed with acromegaly due to his characteristic clinical features, endocrine data, and the presence of pituitary tumor.

Pathological examination of the pituitary tumor after transsphenoidal surgery was compatible with growth hormone (GH)-secreting pituitary adenoma.

We also detected the transcripts and/or immunoreactivity of GH/insulin-like growth factor I components in the tumor specimen.

This is a rare case of acromegaly associated with multiple tumors, including RCC, colon cancer and thyroid tumor.

[MeSH-major] Acromegaly / etiology. Neoplasms, Multiple Primary / complications

[MeSH-minor] Base Sequence. Carcinoma, Renal Cell / complications. Carcinoma, Renal Cell / genetics. Carcinoma, Renal Cell / metabolism. Colonic Neoplasms / complications. Colonic Neoplasms / genetics. Colonic Neoplasms / metabolism. DNA Primers / genetics. Gene Expression. Humans. Immunohistochemistry. Insulin-Like Growth Factor I / genetics. Insulin-Like Growth Factor I / metabolism. Kidney Neoplasms / complications. Kidney Neoplasms / genetics. Kidney Neoplasms / metabolism. Male. Middle Aged. Pituitary Neoplasms / complications. Pituitary Neoplasms / genetics. Pituitary Neoplasms / metabolism. Receptor, IGF Type 1 / genetics. Receptor, IGF Type 1 / metabolism. Receptors, Somatotropin / genetics. Receptors, Somatotropin / metabolism. Thyroid Neoplasms / complications. Thyroid Neoplasms / genetics. Thyroid Neoplasms / metabolism

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(PMID = 19652429.001).

[ISSN] 1349-7235

[Journal-full-title] Internal medicine (Tokyo, Japan)

[ISO-abbreviation] Intern. Med.

[Language] eng

[Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] Japan

[Chemical-registry-number] 0 / DNA Primers; 0 / Receptors, Somatotropin; 67763-96-6 / Insulin-Like Growth Factor I; EC 2.7.10.1 / Receptor, IGF Type 1

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Long-term results of gamma knife surgery for growth hormone-producing pituitary adenoma: is the disease difficult to cure?

OBJECT: The authors conducted a study to determine the long-term results of gamma knife surgery for residual or recurrent growth hormine (GH)-producing pituitary adenomas and to compare the results with those after treatment of other pituitary adenomas.

Growth hormone normalization (GH < 1.0 ng/ml) was found in 4.8%, nearly normal (< 2.0 ng/ml) in 11.9%, significantly decreased (< 5.0 ng/ml) in 23.8%, decreased in 21.4%, unchanged in 21.4%, and increased in 16.7%.

Serum insulin-like growth factor (IGF)-1 was significantly decreased (IGF-1 < 400 ng/ml) in 40.7%, decreased in 29.6%, unchanged in 18.5%, and increased in 11.1%, which was almost parallel to the GH changes.

CONCLUSIONS: Gamma knife surgery was effective and safe for the control of tumors; however, normalization of GH and IGF-1 secretion was difficult to achieve in cases with large tumors and low-dose radiation.

[MeSH-major] Adenoma / secretion. Adenoma / surgery. Human Growth Hormone / secretion. Pituitary Neoplasms / secretion. Pituitary Neoplasms / surgery. Radiosurgery / instrumentation

[MeSH-minor] Adult. Aged. Aged, 80 and over. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Male. Middle Aged. Neoplasm Recurrence, Local. Outcome Assessment (Health Care). Pituitary ACTH Hypersecretion / pathology. Pituitary ACTH Hypersecretion / surgery. Prolactinoma / pathology. Prolactinoma / surgery

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(PMID = 15662793.001).

[ISSN] 0022-3085

[Journal-full-title] Journal of neurosurgery

[ISO-abbreviation] J. Neurosurg.

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] United States

[Chemical-registry-number] 12629-01-5 / Human Growth Hormone

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Evolution of an aggressive prolactinoma into a growth hormone secreting pituitary tumor coincident with GNAS gene mutation.

CONTEXT: Mixed PRL- and GH-secreting pituitary adenomas are relatively common because somatotrophs and lactotrophs share the common somato-mammotroph progenitor lineage.

Conversely, the occurrence of a prolactinoma evolving into clinically and biochemically active acromegaly is a rare phenomenon.

OBJECTIVE AND RESULTS: We report a patient with a prolactinoma who after 15 yr of disease control by bromocriptine became resistant to dopaminergic drugs and due to the rapid tumor growth was submitted to four neurosurgeries and two stereotactic radiotherapies in the subsequent 5 yr.

Unexpectedly, in the last 1.5 yr, after the fourth neurosurgery and second gamma-knife, she complained of signs and symptoms of acromegaly that was biochemically confirmed.

Although samples from the initial surgery were positive for prolactin and negative for GH, about 10% of GH-positive cells were detected in tissue from the last surgery, consistent with the observed clinical shift to acromegaly.

CONCLUSIONS: These observations suggest that 1)treatment of prolactinomas resistant to dopaminergic drugs is still a challenge, and 2) the appearance of gsp oncogene in a prolactinoma evolving into acromegaly might be the underlying mechanism of this rare transition, further confirming that this mutational change is associated with somatotroph growth and transformation.

[MeSH-major] GTP-Binding Protein alpha Subunits, Gs / genetics. Growth Hormone-Secreting Pituitary Adenoma / genetics. Growth Hormone-Secreting Pituitary Adenoma / pathology. Pituitary Neoplasms / pathology. Prolactinoma / pathology

[MeSH-minor] DNA Mutational Analysis. Disease Progression. Female. Follow-Up Studies. Humans. Middle Aged. Mutation / physiology. Neoplasm Invasiveness

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(PMID = 19890024.001).

[ISSN] 1945-7197

[Journal-full-title] The Journal of clinical endocrinology and metabolism

[ISO-abbreviation] J. Clin. Endocrinol. Metab.

[Language] eng

[Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] United States

[Chemical-registry-number] EC 3.6.1.- / GNAS protein, human; EC 3.6.5.1 / GTP-Binding Protein alpha Subunits, Gs

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Ectopic suprasellar growth hormone-secreting pituitary adenoma: case report.

OBJECTIVE: Ectopic pituitary adenomas are rare.

We present an unusual case of an ectopic growth hormone-secreting pituitary adenoma in the suprasellar space.

CLINICAL PRESENTATION: A 31-year-old man presented with a history of chronic headache and typical clinical signs of acromegaly.

Magnetic resonance imaging scans revealed a suprasellar mass not arising from the normal looking pituitary gland.

Histological examination showed a growth hormone-secreting pituitary adenoma CONCLUSION: Although uncommon, growth hormone-secreting pituitary adenomas are encountered in the suprasellar region.

They should be added to the differential diagnosis of tumors in this location.

[MeSH-major] Adenoma / radiography. Choristoma. Growth Hormone-Secreting Pituitary Adenoma / radiography

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(PMID = 17986925.001).

[ISSN] 1524-4040

[Journal-full-title] Neurosurgery

[ISO-abbreviation] Neurosurgery

[Language] eng

[Publication-type] Case Reports; Journal Article; Review

[Publication-country] United States

[Number-of-references] 23

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Cardiac and metabolic effects of chronic growth hormone and insulin-like growth factor I excess in young adults with pituitary gigantism.

Chronic growth hormone (GH)/insulin-like growth factor I (IGF-I) excess is associated with considerable mortality in acromegaly, but no data are available in pituitary gigantism.

The aim of the study was to evaluate the long-term effects of early exposure to GH and IGF-I excess on cardiovascular and metabolic parameters in adult patients with pituitary gigantism.

Six adult male patients with newly diagnosed gigantism due to GH secreting pituitary adenoma were studied and compared with 6 age- and sex-matched patients with acromegaly and 10 healthy subjects.

Disease duration was significantly longer (P<.05) in patients with gigantism than in patients with acromegaly, whereas GH and IGF-I concentrations were comparable.

Left ventricular mass was increased both in patients with gigantism and in patients with acromegaly, as compared with controls.

Left ventricular hypertrophy was detected in 2 of 6 of both patients with gigantism and patients with acromegaly, and isolated intraventricular septum thickening in 1 patient with gigantism.

Inadequate diastolic filling (ratio between early and late transmitral flow velocity<1) was detected in 2 of 6 patients with gigantism and 1 of 6 patients with acromegaly.

Impaired glucose metabolism occurrence was higher in patients with acromegaly (66%) compared with patients with gigantism (16%).

In conclusion, our data suggest that GH/IGF-I excess in young adult patients is associated with morphologic and functional cardiac abnormalities that are similar in patients with gigantism and in patients with acromegaly, whereas occurrence of impaired glucose metabolism appears to be higher in patients with acromegaly, although patients with gigantism are exposed to GH excess for a longer period.

[MeSH-major] Gigantism / complications. Gigantism / metabolism. Human Growth Hormone / blood. Hypertrophy, Left Ventricular / etiology. Hypertrophy, Left Ventricular / metabolism. Insulin-Like Growth Factor I / metabolism

[MeSH-minor] Acromegaly / complications. Acromegaly / metabolism. Adult. Blood Pressure. Echocardiography, Doppler. Electrocardiography. Glucose / metabolism. Glucose Intolerance / etiology. Glucose Intolerance / metabolism. Humans. Male. Ventricular Dysfunction, Left / etiology. Ventricular Dysfunction, Left / metabolism. Ventricular Dysfunction, Left / ultrasonography

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(PMID = 16125529.001).

[ISSN] 0026-0495

[Journal-full-title] Metabolism: clinical and experimental

[ISO-abbreviation] Metab. Clin. Exp.

[Language] eng

[Publication-type] Journal Article; Research Support, Non-U.S. Gov't

[Publication-country] United States

[Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I; IY9XDZ35W2 / Glucose

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Acromegaly without imaging evidence of pituitary adenoma.

CONTEXT: GH-secreting pituitary adenomas are nearly always visible on conventional magnetic resonance (MR) imaging.

However, management and outcome of acromegalic patients lacking imaging evidence of GH-secreting pituitary adenomas are undefined.

OBJECTIVE: The aim was to evaluate surgical exploration for MR-invisible GH-secreting pituitary adenomas.

PATIENTS OR OTHER PARTICIPANTS: Consecutive acromegalic patients without imaging evidence of a pituitary adenoma on pre- and postcontrast, spin echo T1-weighted MR imaging and who lacked evidence of an ectopic (nonpituitary) source causing GH excess were included.

INTERVENTIONS: Surgical exploration with identification and resection of a pituitary adenoma was performed.

MAIN OUTCOME MEASURES: Laboratory values (GH, IGF-I), surgical findings, and clinical outcome were analyzed.

RESULTS: Six patients (three males, three females; 3% of all patients) with suspected GH-secreting adenomas did not demonstrate imaging evidence of pituitary adenoma on conventional MR imaging.

Three patients underwent a postcontrast, volumetric interpolated breath-hold examination MR-imaging sequence (1.2-mm slice thickness), which revealed a 4-mm pituitary adenoma not seen on the spin echo T1-weighted MR imaging in one patient.

A pituitary adenoma was identified and removed in all patients (mean diameter, 5.6 mm; range, 5 to 6.7 mm).

Histological analysis confirmed that the lesions were GH-secreting adenomas.

CONCLUSION: Acromegaly can be caused by GH-secreting pituitary adenomas that are not evident on conventional MR imaging.

Adenomas in some of these patients become evident using volumetric interpolated breath-hold examination MR imaging.

Surgical exploration of the pituitary gland in acromegalic patients with endocrine findings consistent with a GH-secreting adenoma but negative MR imaging can lead to identification and removal of an adenoma.

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(PMID = 20610592.001).

[ISSN] 1945-7197

[Journal-full-title] The Journal of clinical endocrinology and metabolism

[ISO-abbreviation] J. Clin. Endocrinol. Metab.

[Language] ENG

[Grant] United States / Intramural NIH HHS / /

[Publication-type] Case Reports; Journal Article; Multicenter Study; Research Support, N.I.H., Intramural

[Publication-country] United States

[Other-IDs] NLM/ PMC2936064

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] [Acromegaly].

Acromegaly is a rare disease usually caused by growth hormone (GH) hypersecretion, due to a pituitary adenoma; in very rare cases, acromegaly is due to ectopic secretion of GHRH, responsible for pituitary hyperplasia.

Owing to its insidious onset, acromegaly is often diagnosed late (4 to > 10 years after onset), at an average age of about 40 years, in front of an acquired, slowly progressing disfigurement mainly involving the face and extremities.

Acromegaly has also rheumatologic, cardiovascular, respiratory and metabolic consequences which determine its prognosis.

The diagnosis is based on an increased serum GH concentration unsuppressed following an oral glucose load (oral glucose tolerance test -OGTT-) and an increased insulin-like growth factor-I (IGF-I); according to a 2000 Consensus statement, if the basal serum GH is above 0,4microg/L (1.2mIU/L) and/or if the IGF-I is elevated, an OGTT must be performed.

If the lowest GH value (nadir) during OGTT remains above 1microg/L (3mIU/L), acromegaly is confirmed.

Treatment is aimed at correcting (or preventing) tumor compression by excising the culprit lesion, and at reducing GH and IGF-I levels to normal values (or at least to a "safe" GH level of < 2microg/L or < 6mIU/L).

A stepwise therapeutic strategy is used: transsphenoidal surgery is often the first-line treatment; when surgery fails to correct GH/IGF-I hypersecretion, medical treatment with somatostatin analogs and/or radiotherapy can be used, somatostatin analogs being generally preferred; the GH antagonist (pegvisomant) is used in patients that are resistant or intolerant to somatostatin analogs.

Prognosis of acromegaly has improved in the recent years: adequate hormonal disease control is achieved in most cases, allowing life expectancy similar to that of the general population.

[MeSH-major] Acromegaly / etiology

[MeSH-minor] Adenoma / complications. Adenoma / surgery. Age Factors. Glucose Tolerance Test. Human Growth Hormone / antagonists & inhibitors. Human Growth Hormone / blood. Human Growth Hormone / secretion. Humans. Insulin-Like Growth Factor I / analysis. Pituitary Neoplasms / complications. Pituitary Neoplasms / surgery. Prognosis. Risk Factors

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(PMID = 19004612.001).

[ISSN] 2213-0276

[Journal-full-title] Presse medicale (Paris, France : 1983)

[ISO-abbreviation] Presse Med

[Language] fre

[Publication-type] English Abstract; Journal Article; Review

[Publication-country] France

[Chemical-registry-number] 12629-01-5 / Human Growth Hormone; 67763-96-6 / Insulin-Like Growth Factor I

[Number-of-references] 34

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Acromegaly.

Acromegaly is a slowly progressive disease characterized by 30% increase of mortality rate for cardiovascular disease, respiratory complications and malignancies.

The estimated prevalence of the disease is 40 cases/1000000 population with 3-4 new cases/1000000 population per year.

The biochemical diagnosis is based upon the demonstration of high circulating levels of GH and IGF-I.

A random GH level lower than 0.4 microg/l and an IGF-I value in the age- and sex-matched normal range makes the diagnosis of acromegaly unlikely.

In doubtful cases, the lack of GH suppressibility below 1 microg/l (0.3 microg/l according to recent reports) after an oral glucose load will confirm the diagnosis.

A pituitary adenoma is demonstrated in most cases by CT scan or MRI.

A negative X-ray finding or the presence of empty sella do not exclude the diagnosis.

At the moment of diagnosis all patients should undergo colonscopy.

Surgery, radiotherapy and medical treatment represent the therapeutic options for acromegaly.

The outcome of transsphenoidal surgery is far better for microadenomas (80-90%) than for macroadenomas (less than 50%), which unluckily represent more than 70% of all GH-secreting pituitary tumours.

Therefore, pituitary surgery is the first line treatment for microadenomas.

Medical therapy is based on GH-lowering drugs (somatostatin receptor agonists and, in some cases, dopaminergic agents) and GH receptor antagonists (pegvisomant).

However, GH-lowering drugs are also used as primary therapy when surgery is contraindicated or in the case of large GH-secreting macroadenomas which are not likely to be completely removed by surgery.

For the moment pegvisomant is indicated for patients resistant to the GH-lowering drugs and there is no evidence for drug-induced enlargement of the pituitary tumour.

In order to avoid this possibility, however, a combination of pegvisomant and GH-lowering compound can also be conceived.

It is indicated after unsuccessful surgical and/or medical treatment and allows the control of hormonal secretion and tumour growth in approx.

Acromegaly is defined as controlled when, in the absence of clinical activity, IGF-I levels are in the age- and sex-matched normal range and GH is normally suppressible by the oral glucose load.

[MeSH-major] Acromegaly / etiology. Adenoma / complications. Growth Hormone-Secreting Pituitary Adenoma / complications

[MeSH-minor] Algorithms. Biomarkers / blood. Cardiovascular Diseases / etiology. Combined Modality Therapy. Dopamine Agonists / therapeutic use. Glucose Tolerance Test. Hormone Antagonists / therapeutic use. Human Growth Hormone / blood. Humans. Hypophysectomy. Insulin-Like Growth Factor I / analysis. Radiotherapy, Adjuvant. Respiration Disorders / etiology. Sleep Apnea Syndromes / etiology. Somatostatin / analogs & derivatives. Somatostatin / therapeutic use. Treatment Outcome. Up-Regulation

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(PMID = 17077948.001).

[ISSN] 1573-7403

[Journal-full-title] Pituitary

[ISO-abbreviation] Pituitary

[Language] eng

[Publication-type] Journal Article; Review

[Publication-country] United States

[Chemical-registry-number] 0 / Biomarkers; 0 / Dopamine Agonists; 0 / Hormone Antagonists; 12629-01-5 / Human Growth Hormone; 51110-01-1 / Somatostatin; 67763-96-6 / Insulin-Like Growth Factor I

[Number-of-references] 23

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Surgical removal of growth hormone-secreting pituitary adenomas with intensive microsurgical pseudocapsule resection results in complete remission of acromegaly.

Although some investigators recommended surgical removal of the borders between pituitary adenoma and the surrounding normal pituitary gland, there is so far little documentation of how intensive dissection of the border zone affects the actual clinical remission rate of pituitary adenomas.

We investigated the precise histological characteristics of the boundary, using surgical specimens from patients who underwent intensive resection of "microsurgical pseudocapsule" of growth hormone (GH)-secreting pituitary adenomas.

Furthermore, we compared the remission rate of acromegaly between subjects with (Group 1) and without (Group 2) intensive resection of microsurgical pseudocapsule in order to correlate the histological complete resection and endocrinological remission.

Histologically, most adenomas were in direct contact with normal pituitary gland that formed an increased fibrous component facing the adenoma, without a true histological pseudocapsule.

It was impossible to dissect the tumor at exactly the tumor--normal pituitary interface for the whole extent of the pituitary adenoma during surgery, and complete removal of the tumor inevitably included a portion of normal tissue (microsurgical pseudocapsule).

The biochemical remission rate was significantly higher in Group 1 than in Group 2 (90.0 vs 61.1%), and Group 1 showed no additional postoperative pituitary hypofunction.

The present results suggested that intensive resection of the microsurgical pseudocapsule is essential to accomplish histological and endocrinological total resection of the GH-secreting pituitary adenomas for remission of acromegaly.

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(PMID = 15765245.001).

[ISSN] 0344-5607

[Journal-full-title] Neurosurgical review

[ISO-abbreviation] Neurosurg Rev

[Language] eng

[Publication-type] Journal Article

[Publication-country] Germany

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Pegvisomant treatment in gigantism caused by a growth hormone-secreting giant pituitary adenoma.

BACKGROUND: Gigantism is rare with the majority of cases caused by a growth hormone (GH)-secreting pituitary adenoma.

Treatment options for GH-secreting pituitary adenomas have been widened with the availability of long-acting dopamine agonists, depot preparations of somatostatin analogues, and recently the GH receptor antagonist pegvisomant.

CASE REPORT: A 23-year-old male patient presented with continuous increase in height during the past 6 years due to a GH-secreting giant pituitary adenoma.

At immunohistochemistry, the tumour showed a marked expression of GH and a sparsely focal expression of prolactin.

Conversion from somatostatin analogue to pegvisomant normalized insulin-like-growth-factor-I (IGF-I) levels and markedly improved glucose tolerance.

CONCLUSION: Pegvisomant is a potent treatment option in patients with pituitary gigantism.

[MeSH-major] Adenoma / secretion. Adenoma / surgery. Gigantism / drug therapy. Gigantism / etiology. Human Growth Hormone / analogs & derivatives. Human Growth Hormone / secretion. Pituitary Neoplasms / secretion. Pituitary Neoplasms / surgery

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(PMID = 17427111.001).

[ISSN] 0947-7349

[Journal-full-title] Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association

[ISO-abbreviation] Exp. Clin. Endocrinol. Diabetes

[Language] eng

[Publication-type] Case Reports; Journal Article

[Publication-country] Germany

[Chemical-registry-number] 0 / pegvisomant; 12629-01-5 / Human Growth Hormone

   

[Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.

[Title] Acromegaly.

Acromegaly is an acquired disorder related to excessive production of growth hormone (GH) and characterized by progressive somatic disfigurement (mainly involving the face and extremities) and systemic manifestations.

Due to insidious onset and slow progression, acromegaly is often diagnosed four to more than ten years after its onset.

The disease also has rheumatologic, cardiovascular, respiratory and metabolic consequences which determine its prognosis.

In the majority of cases, acromegaly is related to a pituitary adenoma, either purely GH-secreting (60%) or mixed.

In very rare cases, acromegaly is due to ectopic secretion of growth-hormone-releasing hormone (GHRH) responsible for pituitary hyperplasia.

The clinical diagnosis is confirmed biochemically by an increased serum GH concentration following an oral glucose tolerance test (OGTT) and by detection of increased levels of insulin-like growth factor-I (IGF-I).

Echocardiography and sleep apnea testing are used to determine the clinical impact of acromegaly.

Treatment is aimed at correcting (or preventing) tumor compression by excising the disease-causing lesion, and at reducing GH and IGF-I levels to normal values.

When surgery fails to correct GH/IGF-I hypersecretion, medical treatment with somatostatin analogs and/or radiotherapy can be used.

The GH antagonist (pegvisomant) is used in patients that are resistant to somatostatin analogs.

Adequate hormonal disease control is achieved in most cases, allowing a life expectancy similar to that of the general population.

[MeSH-major] Acromegaly. Human Growth Hormone / secretion

[MeSH-minor] Adult. Female. Humans. Male. Middle Aged. Pituitary Neoplasms / metabolism. Pituitary Neoplasms / radiography. Prevalence

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(PMID = 18578866.001).

[ISSN] 1750-1172

[Journal-full-title] Orphanet journal of rare diseases

[ISO-abbreviation] Orphanet J Rare Dis

[Language] eng

[Publication-type] Journal Article; Review

[Publication-country] England

[Chemical-registry-number] 12629-01-5 / Human Growth Hormone

[Number-of-references] 103

[Other-IDs] NLM/ PMC2459162