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Top of pageDiscussion of DiagnosisIn 95% of cases, acromegaly is caused by excessive growth hormone secretion from a pituitary adenoma, and is rarely the result of secretion of growth hormone releasing hormone or growth hormone from an ectopic source.2 Somatotroph adenomas represent 10 of pituitary tumors, and are less common than lactotroph derived or gonadotroph derived adenomas.3 The incidence of acromegaly is 3 million new cases per year in the US, and the prevalence worldwide is [url=http://www.davidhabchy.com]barbour sale[/url] 40 70 cases per million individuals, equally distributed among men and women.4 It is not uncommon for other pituitary hormones to be co secreted, along with growth hormone, in patients with acromegaly, although [url=http://www.fm2k11.it]Moncler Outlet[/url] such co secretion may be asymptomatic.5 In the case described, there was a high degree of gonadotropin subunit immunostaining without proof of co secretion of these subunits. The minimal prolactin immunostaining probably represented co secretion of prolactin by the adenoma, because baseline mild hyperprolactinemia was present and was reversed after surgery. It is also possible, however, that the mild hyperprolactinemia reflected pituitary stalk compression rather than co secretion.5 There is commonly a significant delay from the time of diagnosis to recognition of acromegaly mean of 7 years from the onset of symptoms.6 Recognition of the signs and symptoms of acromegaly (Figure 3) is, therefore, important because early detection and treatment improves prognosis.6 This [url=http://www.lotogame.fr/louboutin-pas-cher/]boutique louboutin paris[/url] patient's primary symptoms were headache and arthritis (symptoms that are present at the time of diagnosis in 60% and 40% of patients with acromegaly, respectively),7 which had been present for at least 4 years before diagnosis.
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