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Sumario Acromegalia resumen
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resumen acerca del diagnostico y tratamiento de la acromegalia
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ACROMEGALIADEFINICION:
Es la consecuencia clínica de la secreción de hormona somatotropa (Hormona
del crecimiento GH) después del cierre de los discos epifisiarios (la anomalía del
cierre de los discos epifisiarios y crecimiento lineal se denomina gigantismo).
ETIOLOGIA:
• El 95% son por Adenomas hipofisiarios (75% macro adenomas y 5% tumor
secretor de GHR en hipotálamo)
• La causa más común de acromegalia ectópica mediada por GHRN es el
tumor carcinoide abdominal (páncreas)
EPIDEMIOLOGIA:
• Asociado a pólipos pre malignos y cáncer de colon
• Incidencia en hombres de 40 a 45 años de edad
• Complicación más frecuente: Diabetes Insípida
• Hay elevación de la PRL hasta en un 25 – 40%
CLINICA:
• Cambio en las facciones
• Prognatismo
• Hiperhidrosis
• Voz grave
• SAOS
• Protuberancia frontal
• Macroglosia
• Artropatía
• Síndrome del túnel del carpo
Si hay compresión del quiasma óptico, puede producir Hemianopsia bitemporal y
cefalea.
Resistencia a la insulina (intolerancia a la glucosa)
DIAGNOSTICO:
• INICIAL: medición de factor decrecimiento similar a la insulina tipo 1 (IGF-1),
su incremento señala una posible acromegalia
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