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Acromegaly in the elderly patients

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Abstract

Background

Acromegaly is a rare disease characterized by a chronic exposition to growth hormone (GH) and insulin-like growth factor-1 (IGF-1), caused in most cases by a pituitary GH-secreting adenoma. Chronic GH excess induces systemic complications (metabolic, cardiovascular, respiratory, neoplastic, and musculoskeletal) and increased mortality if not appropriately treated. Recent epidemiological data report an improved life span of patients with acromegaly probably due to better acromegaly management; additionally, the number of pituitary incidentaloma in general population also increased over time due to more frequent imaging. Therefore, the number of elderly patients, newly diagnosed with acromegaly or in follow-up, is expected to grow in the coming years and clinicians will need to be aware of particularities in managing these patients.

Purpose

This review aims to explore different aspects of acromegaly of the elderly patients, focusing on epidemiology, diagnosis, clinical presentation, complications, and management options.

Methods

Available literature has been assessed through PubMed (data until August 2019) by specific keywords.

Conclusions

Available data on acromegaly in the elderly patient are sparse, but point to important differences. Further studies are needed comparing elderly with younger patients with acromegaly to better define a tailored diagnostic and therapeutic management.

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Funding

This study was supported by funding from the University of Ferrara to MCZ and MRA (FAR2019).

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Authors and Affiliations

  1. Section of Endocrinology & Internal Medicine, Dept of Medical Sciences, University of Ferrara, Ferrara, Italy

    Maria Rosaria Ambrosio, Irene Gagliardi, Marta Bondanelli & Maria Chiara Zatelli

  2. Pituitary Unit, Department of Endocrinology, Fondazione A Gemelli, IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy

    Sabrina Chiloiro, Antonella Giampietro, Antonio Bianchi & Laura De Marinis

  3. Endocrinology and Diabetes Department, Garcia de Orta Hospital, Almada, Portugal

    Ana Gonçalves Ferreira

  4. Northwest Pituitary Center, Departments of Medicine and Neurological Surgery, Oregon Health & Science University, Portland, OR, USA

    Maria Fleseriu

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  1. Maria Rosaria Ambrosio
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  2. Irene Gagliardi
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  3. Sabrina Chiloiro
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  4. Ana Gonçalves Ferreira
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  9. Maria Fleseriu
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  10. Maria Chiara Zatelli
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Correspondence to Maria Chiara Zatelli.

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Conflict of interest

MRA reports registration fees for scientific meetings from Ipsen, Novartis, Pfizer, and Savio Pharma. LDM reports that she has been Principal Investigator for clinical trials for Novartis, Ipsen, Pfizer, and Chiasma. MF has been a principal investigator for studies with research grants to Oregon Health & Science University from Chiasma, Crinetics, Ionis, Novartis, Pfizer and has been an occasional scientific consultant to Chiasma, Crinetics, Ipsen, Novartis, Pfizer. MCZ received consulting fees from Sanofi, Novartis and Ipsen; received financial support for scientific meetings and for research support from Itapharma, Abiogen, Sanofi, Novartis and Ipsen. IG, SC, AGF, MB, AG, AB have no actual or potential conflict of interest in relation to this paper.

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Ambrosio, M.R., Gagliardi, I., Chiloiro, S. et al. Acromegaly in the elderly patients. Endocrine 68, 16–31 (2020). https://doi.org/10.1007/s12020-020-02206-7

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