Endocrinology: hormones, adenoma hypophysis, pituitary tumor

Grigoriev, A. Yu, Zuev, AA, Voskobojnikov VV Kuznetsov, NS

PG Endocrinology Research Center RAMS, Moscow.

II Scientific-practical conference of neurologists and neurosurgeons south of Russia, on the 80 th anniversary of VV Martirosian, Rostov-on-Don.

Acromegaly - a condition that is caused by hyperproduction of somatotropin (STH). In most cases, the cause of overproduction of GH is pituitary adenoma. Mortality of patients with acromegaly in 10 times greater than in the population, mainly due to cardiovascular complications. Surgical treatment has traditionally been considered first-line treatment.

The purpose of the study.

To assess the results of surgical treatment of patients with acromegaly and determine the prognostic significance of early results for the final outcome of therapy.

Material and methods.

We analyzed early and late results transsfenoidalnogo removal of somatotropin in 47 patients operated on in Enz RAMS from 1997 to 2005. Of these women was 34 (72,3%), men - 13 (27,7%). The average age was 44,7 ± 15,3 years. Endosellyarnye tumors were 12 patients (25,5%), endo-ekstrasellyarnye - in 35 (74,5%), and in 11 (31,4%) patients the tumor extended suprasellar, 8 (22,9%) - infrasellyarno , at 5 (14,3%) - laterosellyarno and in 11 (31,4%) patients in two or more directions.

All patients underwent removal of pituitary adenoma was performed initially. The criterion for remission was: basal GH level in a year after the operation, <5 mU / L (<2 mg / l), GH levels after oral glyukozotollerantnogo test <2 mU / liter (<1 mg / l), normal levels of IGF - 1 .

Results and discussion.

The study group 1 year after adenomectomy in 29 patients (61.7%) patients had marked clinical and hormonal remission of the disease (group A), 3 (6,4%) - partial remission (group B) and in 15 (31 , 9%) - the effect of the operation has been received (group C).

All patients in whom early postoperative period showed a decrease of basal level of GH <5 mU / L (<2 mg / l), the level of GH after oral glyukozotollerantnogo test <2 mU / liter (<1 ug / L) and normalized IGF - 1, 12 months after the operation has developed clinical and hormonal remission of acromegaly.

Patients who in the early postoperative period did not have the reduction of GH and IGF-1, but they showed a decrease to normal levels of GH values at 12 months after surgery in 52.6% cases had clinical and hormonal remission of the disease (group A) in 15,8% - the improvement in general condition, normalization of basal GH levels (group B), in 31,6% of cases - there was no remission (group C). All patients who had no decrease in basal level of GH in the early period after surgery, 12 months after surgery, clinical and hormonal remission is not indicated (group C).

Based on these data, we can conclude that patients who have not been required to reduce basal levels of GH, but there was a normalization of it, in the early postoperative period is recommended to monitor the timely appointment of second-line treatments. All patients with elevated basal level of growth hormone in 5 - 7 days after surgery (Group C) shows the early administration of drug therapy (somatostatin analogues, dopamine agonists, etc.) with a subsequent decision of the holding of re-operation, radiation therapy or continuation of medical treatment.

Endocrinology directory:
Disease (diseases): disruption of vital activity.

Endocrine diseases (endocrine diseases): a violation of the endocrine system.

Thyroid gland (thyroid gland, thyroid body, glandula thyreoidea), endocrine organs produce and accumulate iodsoderzhaschie hormones.
Hormones are involved in the regulation of metabolism in the body.
Symptoms of endocrine diseases
acromegaly,

disease caused by excessive production of somatotropin, characterized by disproportionate growth of bones, soft tissues and internal organs.
Itsenko - Cushing's disease-

(On behalf of the Soviet neuropathologist NM Itsenko, 1889-1954, and the American neurosurgeon HW Cushing (N. W. Cushing, 1869-1939), a disease caused by increased secretion of adrenocorticotropic hormone (ACTH), pituitary gland, followed by increased function adrenals.
Appears obesity, hypertension, hirsutism in women, osteoporosis, diabetes mellitus, decreased function of sexual glands, dry skin, etc. (TSB)
giperinsulizm-

(Hypoglycemic disease) - a disease characterized by bouts of hypoglycemia, caused by absolute or relative increase in insulin levels.
obesity-

disease characterized by excessive development of adipose tissue. Obesity occurs more often after 40 years, mostly women.