Management of the patient with acromegaly

GH: growth hormone; IGF-1: insulin-like growth factor-1; MRI: magnetic resonance imaging.
* The diagnosis of acromegaly should be suspected in patients with typical features of GH excess (ie, enlarged jaw, hands, and feet; coarse facial features), pituitary mass, and elevated serum IGF-1. The diagnosis may then be confirmed by inadequate suppression of serum GH after a glucose load.
¶ Refer to UpToDate topics on medical therapy for acromegaly.
Δ Stereotactic radiotherapy - single-dose radiotherapy; most common method is the Gamma Knife. Normalization of serum IGF-1 may take >10 years. Medical therapy continued in the interim. Refer to UpToDate topics on medical therapy for acromegaly.