Overview of Acromegaly
Acromegaly is a rare endocrine disease with an estimated incidence of three to four cases per million and a prevalence of 40-70 cases per million43, though a recent Belgian study suggested a higher prevalence of 13 cases per 100,000.17 The disease is most often caused by secretion of excess growth hormone (GH) from a benign adenoma of the GH-producing somatotroph cells in the anterior pituitary gland. Rarely, acromegaly is attributable to hypothalamic or ectopic secretion of growth hormone releasing hormone (GHRH).
Excess GH, normally produced in a pulsatile fashion by the pituitary gland, stimulates hepatic secretion of insulin-like growth factor-1 (IGF-1), which is responsible for most of the clinical manifestations of acromegaly. GH-secreting adenomas are usually sporadic, but may occur as part of a familial syndrome, such as multiple endocrine neoplasia type-1 (MEN-1).21