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[PMID]:29267504
[Au] Autor:Mendes GA; Haag T; Trott G; Rech CGSL; Ferreira NP; Oliveira MC; Kohek MB; Pereira-Lima JFS
[Ad] Endereço:Programa de Pós-Graduação em Patologia, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brasil.
[Ti] Título:Expression of E-cadherin, Slug and NCAM and its relationship to tumor invasiveness in patients with acromegaly.
[So] Source:Braz J Med Biol Res;51(2):e6808, 2017 Dec 11.
[Is] ISSN:1414-431X
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Pituitary adenomas account for 10-15% of primary intracranial tumors. Growth hormone (GH)-secreting adenomas account for 13% of all pituitary adenomas and cause acromegaly. These tumors can be aggressive, invade surrounding structures and are highly recurrent. The objective of this study was to evaluate E-cadherin, Slug and neural cell adhesion molecule (NCAM) expression in GH-secreting pituitary adenomas and its relationship to tumor invasiveness. A cross-sectional study of patients who underwent hypophysectomy due to GH-secreting pituitary adenoma from April 2007 to December 2014 was carried out. The medical records were reviewed to collect clinical data. Immediately after surgery, tumor samples were frozen in liquid nitrogen and stored in a biofreezer at -80°C for assessment of E-cadherin 1 (CDH1), SLUG (SNAI2), and NCAM (NCAM1) by real-time PCR. The samples were fixed in formalin and embedded in paraffin for immunohistochemical analysis of E-cadherin and NCAM. Thirty-five patients with acromegaly were included in the study. Of these, 65.7% had invasive tumors. Immunohistochemically, E-cadherin was expressed in 96.7% of patients, and NCAM in 80% of patients. There was no statistically significant relationship between tumor grade or invasiveness and immunohistochemical expression of these markers. Regarding gene expression, 50% of cases expressed CDH1, none expressed SNAI2, and 53.3% expressed NCAM1. There was no statistically significant relationship between tumor grade or invasiveness and gene expression of CDH1, SNAI2, and NCAM1. The absence of Slug overexpression and of E-cadherin and NCAM suppression suggests that expression of these markers is not associated with tumor invasiveness in GH-secreting pituitary adenomas.
[Mh] Termos MeSH primário: Acromegalia/patologia
Adenoma/patologia
Caderinas/análise
Moléculas de Adesão de Célula Nervosa/análise
Neoplasias Hipofisárias/patologia
Fatores de Transcrição da Família Snail/análise
[Mh] Termos MeSH secundário: Acromegalia/genética
Acromegalia/metabolismo
Adenoma/química
Adenoma/genética
Adolescente
Adulto
Idoso
Biomarcadores Tumorais/análise
Antígeno CD56/análise
Estudos Transversais
Feminino
Expressão Gênica
Seres Humanos
Imuno-Histoquímica
Masculino
Meia-Idade
Gradação de Tumores
Invasividade Neoplásica
Neoplasias Hipofisárias/química
Neoplasias Hipofisárias/genética
Reação em Cadeia da Polimerase em Tempo Real
Estatísticas não Paramétricas
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (CD56 Antigen); 0 (Cadherins); 0 (NCAM1 protein, human); 0 (Neural Cell Adhesion Molecules); 0 (SNAI1 protein, human); 0 (Snail Family Transcription Factors)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


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[PMID]:29339530
[Au] Autor:Kasuki L; Wildemberg LE; Gadelha MR
[Ad] Endereço:Neuroendocrinology Research Center/Endocrine Section and Medical SchoolHospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
[Ti] Título:MANAGEMENT OF ENDOCRINE DISEASE: Personalized medicine in the treatment of acromegaly.
[So] Source:Eur J Endocrinol;178(3):R89-R100, 2018 Mar.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Acromegaly is associated with high morbidity and elevated mortality when not adequately treated. Surgery is the first-line treatment for most patients as it is the only one that can lead to immediate cure. In patients who are not cured by surgery, treatment is currently based on a trial-and-error approach. First-generation somatostatin receptor ligands (fg-SRL) are initiated for most patients, although approximately 25% of patients present resistance to this drug class. Some biomarkers of treatment outcome are described in the literature, with the aim of categorizing patients into different groups to individualize their treatments using a personalized approach. In this review, we will discuss the current status of precision medicine for the treatment of acromegaly and future perspectives on the use of personalized medicine for this purpose.
[Mh] Termos MeSH primário: Acromegalia/tratamento farmacológico
Adenoma/tratamento farmacológico
Agonistas de Dopamina/uso terapêutico
Adenoma Hipofisário Secretor de Hormônio do Crescimento/tratamento farmacológico
Medicina de Precisão
Receptores da Somatotropina/antagonistas & inibidores
Somatostatina/análogos & derivados
[Mh] Termos MeSH secundário: Seres Humanos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Dopamine Agonists); 0 (Receptors, Somatotropin); 51110-01-1 (Somatostatin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180118
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-1006


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[PMID]:29297640
[Au] Autor:Kolesnikova LI; Madaeva IM; Semenova NV; Osipova EV; Darenskaya MA
[Ti] Título:Serum Myokines Levels in Patients with Endogenous Cushing Syndrome and Acromegaly: Cross-Sectional Case−Control Study.
[So] Source:Vestn Ross Akad Med Nauk;71(3):240-7, 2016.
[Is] ISSN:0869-6047
[Cp] País de publicação:Russia (Federation)
[La] Idioma:eng
[Ab] Resumo:Background: Myokines are produced and released by muscle cells in response to muscular contractions. Endogenous Cushing syndrome (CS) and acromegaly cause significant changes in muscle tissue leading to atrophy or hypertrophy. However, there is no data whether these endocrine abnormalities influence myokine secretion. Aims: To evaluate serum levels of myostatin, interleukin-6 (IL6) and irisin in patients with CS and acromegaly. Materials and Methods: Fasting serum samples were taken and stored in aliquot at ≤-20°C from consecutive subjects with clinically evident and biochemically confirmed active CS, acromegaly and healthy volunteers matched by age, sex and body mass index (BMI). Commercially available kits were used to assay serum myokine levels. Grip strength was measured by a dynamometer. Insulin-like growth factor-1 (IGF1) was measured by immunochemiluminescence assay (Liaison), twenty-four hours urine free cortisol (24hUFC) ­ by immunochemiluminescence assay (Vitros ECi), salivary free cortisol ­ by electrochemiluminescence assay (Cobas). One-way ANOVA was utilized to assess the difference between groups. Results: We enrolled 88 subjects: 30 patients suffered from CS (group 1), 28 ­ acromegaly (2) and 30 matched healthy controls (3) with no difference among the groups in sex, age and BMI (p=0.492, 0.062 and 0.174 respectively). Mean 24hUFC in subjects with CS and mean IGF1 in subjects with acromegaly were significantly higher as compared to other groups (p<0.001). Right-hand grip strength was lower in patients with CS as compared to both patients with acromegaly and healthy subjects (p=0.04). However, among these young adults we did not find statistically significant differences in measured myokines levels: irisin ­ p=0.15; IL6 ­ p=0.34; myostatin ­ p=0.50. There was a significant correlation between myostatin and irisin in the whole group of people and in every separately analyzed subset of patients (p<0.001), but no correlation was found between any measured myokines and 24hUFC or IGF1. Conclusions: Hypercortisolism or supraphysiological IGF1 levels do not significantly influence serum levels of myostatin, IL6 and irisin in young adults.
[Mh] Termos MeSH primário: Acromegalia
Fibronectinas/sangue
Fator de Crescimento Insulin-Like I
Interleucina-6/sangue
Músculo Esquelético
Miostatina/sangue
[Mh] Termos MeSH secundário: Acromegalia/etiologia
Acromegalia/metabolismo
Acromegalia/fisiopatologia
Adulto
Síndrome de Cushing/complicações
Feminino
Seres Humanos
Fator de Crescimento Insulin-Like I/análise
Fator de Crescimento Insulin-Like I/metabolismo
Masculino
Contração Muscular/fisiologia
Músculo Esquelético/metabolismo
Músculo Esquelético/fisiopatologia
Estatística como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (FNDC5 protein, human); 0 (Fibronectins); 0 (Interleukin-6); 0 (Myostatin); 67763-96-6 (Insulin-Like Growth Factor I)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180104
[St] Status:MEDLINE
[do] DOI:10.15690/vramn659


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[PMID]:29236425
[Au] Autor:Willenberg V; Bamblett M; Cummins M; Hoberg D
[Ti] Título:Review of a home nursing injection service: SHINE.
[So] Source:Aust Nurs Midwifery J;22(6):30-3, 2014 12.
[Is] ISSN:2202-7114
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:The SHINE home injection service is part of a patient support program run by Novartis. SHINE is for people prescribed octreotide long-acting release (Sandostatin LAR) for neuroendocrine tumours (NETs) and acromegaly. SHINE has been running in Australia since 2009. The service is run by a third-party and administered by homecare (SHINE) nurses. Five hundred people with NETs or acromegaly have been involved since the service started. We review our collective experience of the benefits of SHINE, and make recommendations for future development. We hope this review provides guidance for developing future home injection service.
[Mh] Termos MeSH primário: Acromegalia/tratamento farmacológico
Antineoplásicos Hormonais/administração & dosagem
Assistência Domiciliar
Tumores Neuroendócrinos/tratamento farmacológico
Octreotida/administração & dosagem
[Mh] Termos MeSH secundário: Acromegalia/enfermagem
Austrália
Preparações de Ação Retardada
Esquema de Medicação
Feminino
Seres Humanos
Injeções
Masculino
Tumores Neuroendócrinos/enfermagem
Avaliação de Programas e Projetos de Saúde
[Pt] Tipo de publicação:RESEARCH SUPPORT, NON-U.S. GOV'T; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents, Hormonal); 0 (Delayed-Action Preparations); RWM8CCW8GP (Octreotide)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:171214
[St] Status:MEDLINE


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[PMID]:28740584
[Au] Autor:Sharma MD; Nguyen AV; Brown S; Robbins RJ
[Ad] Endereço:Houston Methodist Hospital, Houston, Texas.
[Ti] Título:Cardiovascular Disease in Acromegaly.
[So] Source:Methodist Debakey Cardiovasc J;13(2):64-67, 2017 Apr-Jun.
[Is] ISSN:1947-6108
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In patients with acromegaly, chronic excess of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) leads to the development of acromegalic cardiomyopathy. Its main features are biventricular hypertrophy, diastolic dysfunction, and in later stages, systolic dysfunction and congestive heart failure. Surgical and/or pharmacological treatment of acromegaly and control of cardiovascular risk factors help reverse some of these pathophysiologic changes and decrease the high risk of cardiovascular complications.
[Mh] Termos MeSH primário: Acromegalia/fisiopatologia
Doenças Cardiovasculares/fisiopatologia
Sistema Cardiovascular/fisiopatologia
[Mh] Termos MeSH secundário: Acromegalia/sangue
Acromegalia/diagnóstico
Acromegalia/epidemiologia
Doenças Cardiovasculares/sangue
Doenças Cardiovasculares/diagnóstico
Doenças Cardiovasculares/epidemiologia
Sistema Cardiovascular/metabolismo
Hormônio do Crescimento Humano/sangue
Seres Humanos
Fator de Crescimento Insulin-Like I/metabolismo
Prognóstico
Fatores de Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (IGF1 protein, human); 12629-01-5 (Human Growth Hormone); 67763-96-6 (Insulin-Like Growth Factor I)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE
[do] DOI:10.14797/mdcj-13-2-64


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[PMID]:29215515
[Au] Autor:Martini AE; Zolton JR; DeCherney AH
[Ad] Endereço:Department of Obstetrics and Gynecology, Rush University Medical Center, Chicago, Illinois; and the National Institutes of Health, Bethesda, Maryland.
[Ti] Título:Isolated Absent Thelarche in a Patient With Neurofibromatosis Type 1 and Acromegaly.
[So] Source:Obstet Gynecol;131(1):96-99, 2018 Jan.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Isolated absent thelarche is a rare condition that is infrequently reviewed in the literature. CASE: A 28-year-old woman with neurofibromatosis type 1 and acromegaly presented with absent breast development despite hormone therapy. Examination noted a normally developed woman with acromegalic features and Tanner stage I breasts. Hormone studies and karyotype were normal. Magnetic resonance imaging of the patient's brain demonstrated a voluminous pituitary. Chromosome microarray analysis diagnosed the neurofibromatosis 1 microdeletion syndrome. Breast ultrasonography and surgical consultation were offered. CONCLUSIONS: Neither neurofibromatosis type 1, acromegaly, nor neurofibromatosis 1 microdeletion syndrome are linked to absent thelarche. After attempting hormone therapy, patients with absent thelarche should be evaluated for congenital breast anomalies, estrogen receptor abnormalities, or gene defects. Psychological and surgical consultation should also be offered.
[Mh] Termos MeSH primário: Acromegalia/diagnóstico
Mama/anormalidades
Estrogênios/uso terapêutico
Neurofibromatose 1/diagnóstico
[Mh] Termos MeSH secundário: Acromegalia/complicações
Acromegalia/genética
Adulto
Mama/efeitos dos fármacos
Mama/crescimento & desenvolvimento
Feminino
Seres Humanos
Neurofibromatose 1/complicações
Neurofibromatose 1/genética
Doenças Raras
Medição de Risco
Falha de Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Estrogens)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002389


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[PMID]:28742298
[Au] Autor:Ivry G; Felsenfeld AL
[Ti] Título:Acromegaly: A Dental Disease?
[So] Source:J Calif Dent Assoc;44(9):577-80, 2016 Sep.
[Is] ISSN:1043-2256
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Acromegaly is a serious disease that affects the pituitary gland causing unusual growth in patients. There are various dental manifestation of the condition and it is plausible that a dentist will be the first to recognize the problem. This article describes the disease and the dental implications for patients who have it.
[Mh] Termos MeSH primário: Acromegalia/complicações
Doenças Estomatognáticas/etiologia
[Mh] Termos MeSH secundário: Algoritmos
Seres Humanos
Doenças Estomatognáticas/diagnóstico
Doenças Estomatognáticas/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180102
[Lr] Data última revisão:
180102
[Sb] Subgrupo de revista:D
[Da] Data de entrada para processamento:170726
[St] Status:MEDLINE


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[PMID]:28993415
[Au] Autor:Dal J; Klose M; Heck A; Andersen M; Kistorp C; Nielsen EH; Bollerslev J; Feldt-Rasmussen U; Jørgensen JOL
[Ad] Endereço:Department of Endocrinology and Internal MedicineAarhus University Hospital, Aarhus, Denmark.
[Ti] Título:Targeting either GH or IGF-I during somatostatin analogue treatment in patients with acromegaly: a randomized multicentre study.
[So] Source:Eur J Endocrinol;178(1):67-76, 2018 Jan.
[Is] ISSN:1479-683X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:CONTEXT: Discordant GH and IGF-I values are frequent in acromegaly. The clinical significance and its dependence on treatment modality and of glucose-suppressed GH (GH ) measurements remain uncertain. OBJECTIVE: To evaluate the effects of targeting IGF-I GH during somatostatin analogue (SA) treatment. PATIENTS AND METHODS: 84 patients with controlled acromegaly after surgery ( = 23) or SA ( = 61) underwent a GH profile including an OGTT, at baseline and after 12 months. SA patients were randomized to monitoring according to either IGF-I ( = 33) or GH ( = 28). SA dose escalation was allowed at baseline and 6 months. MAIN OUTCOME MEASURES: GH and IGF-I at baseline and 12 months, and disease-specific Quality of Life (QoL). RESULTS: IGF-I and fasting GH levels were comparable between the surgery and the SA group, whereas GH (µg/L) was lower in the surgery group (GH 0.7 ± 0.1 vs 0.3 ± 0.1, < 0.01). SA dose increase was performed in 20 patients in the GH group and in 8 patients in the IGF-I group ( = 0.02), which increased the number of concordantly controlled patients ( = 0.01). QoL was only mildly affected at baseline in all groups and did not changed consistently during the study. CONCLUSION: (1) Discordant values in terms of high GH levels are prevalent in SA patients and more so if applying glucose-suppressed GH ; (2) targeting discordant levels of either GH or IGF-I translates into SA dose increase and improved biochemical control; (3) even though QoL was not improved in this study, we suggest biochemical assessment of disease activity to include glucose-suppressed GH also in SA patients.
[Mh] Termos MeSH primário: Acromegalia/sangue
Acromegalia/tratamento farmacológico
Sistemas de Liberação de Medicamentos/métodos
Hormônio do Crescimento Humano/sangue
Fator de Crescimento Insulin-Like I/metabolismo
Somatostatina/análogos & derivados
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Prospectivos
Método Simples-Cego
Somatostatina/administração & dosagem
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
12629-01-5 (Human Growth Hormone); 51110-01-1 (Somatostatin); 67763-96-6 (Insulin-Like Growth Factor I)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171128
[Lr] Data última revisão:
171128
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171011
[St] Status:MEDLINE
[do] DOI:10.1530/EJE-17-0546


  9 / 7448 MEDLINE  
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[PMID]:28943223
[Au] Autor:Cortet-Rudelli C
[Ad] Endereço:CHRU de Lille, hôpital Huriez, service d'endocrinologie, diabétologie et maladies métaboliques, rue Polonowski, 59037 Lille cedex, France. Electronic address: c.cortet@gmail.com.
[Ti] Título:[The mouth of patients with acromegaly].
[Ti] Título:La bouche de l'acromégale..
[So] Source:Presse Med;46(9):831-837, 2017 Sep.
[Is] ISSN:2213-0276
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Orofacial changes are frequent in acromegaly. Their evolution is slowly progressive. The lips (everted and thickened), the mandibular morphology (prognathism), the tongue (macroglossia), the soft palate and the uvula (increased and thickened), the parodontis (gingival hyperplasia, paradontitis), the teeth (increased interdental spaces, hypercementosis, increased dental mobility, multiple tooth loss) are concerned. Functional consequences are significant (obstructive sleep apnea syndrome, malocclusion, pain of the oral maxillofacial area, decrease of the quality of life). They are rarely noticed as the first symptoms of the disease and rarely responsible for the diagnosis of acromegaly because of a progressive development over a long period of time, and because of the low prevalence of the disease which can be unknown by dentists and dental surgeons. When patients are cured or well-controlled, abnormalities of soft tissues improve but are not always completely reversible and bone enlargement remain unchanged. If any corrective surgical procedures are to be performed, this should be carried out only after normalization of GH and IGF I levels.
[Mh] Termos MeSH primário: Acromegalia/diagnóstico
Facies
Doenças da Boca/diagnóstico
Odontopatias/diagnóstico
[Mh] Termos MeSH secundário: Acromegalia/sangue
Acromegalia/complicações
Acromegalia/terapia
Hormônio do Crescimento Humano/sangue
Seres Humanos
Fator de Crescimento Insulin-Like I/metabolismo
Doenças da Boca/sangue
Doenças da Boca/terapia
Prognóstico
Valores de Referência
Odontopatias/sangue
Odontopatias/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (IGF1 protein, human); 12629-01-5 (Human Growth Hormone); 67763-96-6 (Insulin-Like Growth Factor I)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171013
[Lr] Data última revisão:
171013
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170926
[St] Status:MEDLINE


  10 / 7448 MEDLINE  
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[PMID]:28904697
[Au] Autor:Anoun N; El Ouahabi H
[Ad] Endereço:Service d'Endocrinologie, Diabétologie et Nutrition, CHU Hassan II de Fès, Maroc.
[Ti] Título:[Acromegaly features in the aging population].
[Ti] Título:L'acromégalie du sujet âgé: quelles particularités?.
[So] Source:Pan Afr Med J;27:169, 2017.
[Is] ISSN:1937-8688
[Cp] País de publicação:Uganda
[La] Idioma:fre
[Ab] Resumo:Somatotroph adenomas are rare in the aging population. Diagnosis of somatotroph adenomas is often long delayed and they are characterized by atypical clinical picture. Their diagnostic criteria are similar to those used for younger patients. Surgery, if possible, is the treatment of choice for acromegaly in the elderly. Somatostatin analogues have shown to be effective in these patients. Prognosis is inversely correlated with patient's age, duration of disease and last GH level under treatment. Beside evolution of disease, age is a major determinant of mortality. We report three cases of elderly patients with acromegaly aged 75, 70 and 66 years respectively with a literature review.
[Mh] Termos MeSH primário: Acromegalia/diagnóstico
Hormônio do Crescimento/metabolismo
Somatostatina/administração & dosagem
[Mh] Termos MeSH secundário: Acromegalia/patologia
Acromegalia/terapia
Fatores Etários
Idoso
Feminino
Seres Humanos
Prognóstico
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
51110-01-1 (Somatostatin); 9002-72-6 (Growth Hormone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170922
[Lr] Data última revisão:
170922
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.11604/pamj.2017.27.169.11518



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BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde