Akromegali
aşırı büyüme hormonu (BH) salınımı
sonucu ortaya çıkan klinik sendromdur. Akromegalinin en sık nedeni ön hipofizde
BH salgılayan adenomdur. Akromegali başlangıcı sinsi ve genellikle yavaş
seyirlidir. Hemen hemen tüm hastalarda akral kemik ve yumuşak dokularda aşırı
büyüme mevcuttur. Karakteristik bulgular alt çene çıkıklığı, el ve ayak büyümesidir.
Akromegali hastalarında kardiyovasküler hastalık, kolon kanseri, tiroid kanseri
ve diğer tümörlerde risk artışı görülmektedir. Ölüm genellikle kardiyovasküler
hastalıklar nedeniyle olmaktadır. Akromegalinin temel tedavisi transsfenoidal
cerrahidir. Cerrahi sonrası kür sağlanmazsa uzun etkili somatostatin
analogları, kabergolin, pegvisomant gibi medikal tedaviler kullanılır. Medikal
tedaviye rağmen BH/IGF-1 veya adenom boyutunda artış olursa reoperasyon veya radyoterapi
kullanılabilir.
Acromegaly
is the clinical syndrome that results from excessive secretion of growth
hormone (GH). The most common cause of acromegaly is a GH secreting adenoma of
the anterior pituitary. The onset of acromegaly is insidious, and its
progression is usually very slow. Nearly all patients with acromegaly have
acral osseous and soft tissue overgrowth. The characteristic findings are an
enlarged jaw and enlarged, swollen hands and feet. Patients with acromegaly
appear to be at increased risk for cadiovascular disase, colon cancer, thyroid
cancer and other tumors. Death is generally caused by cardiovascular diseases. Transsphenoidal
surgery is the main therapy for patients with an acromegaly. After surgical
failure long-acting somatostatin analog, cabergolin or pegvisomant are
indicated. If adenoma size increases or GH/IGF-1
hypersecretion persists despite medical therapy, we suggest radiation therapy
(RT) or repeat surgery.
Primary Language | Turkish |
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Subjects | Health Care Administration |
Journal Section | Review |
Authors | |
Publication Date | April 1, 2019 |
Published in Issue | Year 2019 |
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Assoc. Prof. Alpaslan TANOĞLU (MD)
Prof. Aydın ÇİFCİ (MD)
Prof. İbrahim Celalaettin HAZNEDAROĞLU (MD)
Prof. Murat KEKİLLİ (MD)
Prof. Yavuz BEYAZIT (MD)
Prof. Ekrem ÜNAL (MD)
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Assoc. Prof. Bekir UÇAN (MD)
Assoc. Prof. Mehmet Sinan DAL (MD)
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