Claessen Kim M J A, Mazziotti Gherardo, Biermasz Nienke R, Giustina Andrea
Department of Endocrinology and Metabolism, Leiden University Medical Center, Leiden, The Netherlands.
Neuroendocrinology. 2016;103(1):86-95. doi: 10.1159/000375450. Epub 2015 Jan 29.
Acromegaly is a chronic, progressive disease caused by a growth hormone (GH)-producing pituitary adenoma, resulting in elevated GH and insulin-like growth factor 1 concentrations. Following appropriate therapy (surgery, radiotherapy and/or medical treatment), many systemic GH-induced comorbid conditions improve considerably. Unfortunately, despite biochemical control, acromegaly patients suffer from a high prevalence of late manifestations of transient GH excess, significantly impairing their quality of life. In this overview article, we summarize the pathophysiology, diagnosis, clinical picture, disease course and management of skeletal complications of acromegaly, focusing on vertebral fractures and arthropathy.
肢端肥大症是一种由分泌生长激素(GH)的垂体腺瘤引起的慢性进行性疾病,导致GH和胰岛素样生长因子1浓度升高。经过适当治疗(手术、放疗和/或药物治疗)后,许多全身性GH诱导的合并症会有显著改善。不幸的是,尽管实现了生化控制,但肢端肥大症患者仍有很高比例出现短暂性GH分泌过多的晚期表现,严重损害他们的生活质量。在这篇综述文章中,我们总结了肢端肥大症骨骼并发症的病理生理学、诊断、临床表现、病程及管理,重点关注椎体骨折和关节病。