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DOI: http://dx.doi.org/10.18370/2309-4117.2015.26.76-80


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ORCID: 0000-0003-0766-2907

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/REFERENCES
1. Legro, R.S., Arslanian, S.A., Ehrmann, D.A., et al.
Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab, pub. online Oct 24, 2013.
DOI: 10.1210/jc.2013-2350
2. American Association of clinical endocrinologists.
Medical Guidelines for clinical practice for the diagnosis and treatment of acromegaly 2011 Update. Endocr Pract, 2011.
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ACROMEGALY: RARELY OR NOT TIMELY DETECTION DISEASE? REPRODUCTIVE ASPECTS OF PATHOLOGY
Review of the American Association of Clinical Endocrinologists Medical Guidelines for clinical practice for the diagnosis and treatment of acromegaly
O.V. Rykova, head of the Clinical Branch of Laboratory Diagnostics, Medical Laboratory Synevo
The article describes the issues of acromegaly diagnostics in accordance with American Association of Clinical Endocrinologists Medical Guidelines for clinical practice for the diagnosis and treatment of acromegaly 2011 update.
The late diagnosis is a criticality problem: about 7-10 years takes after the first symptoms, which lead to a deterioration in the treatment efficiency of acromegaly and comorbid conditions, reduce the quality of patients life.
Clinical manifestations of acromegaly are the result of continuous impact of the hypersecretion of growth hormone (somatotropin) and, as a consequence, high levels of growth factors, mainly insulin-like growth factor-1, and
the developing hypopituitarism and exposure of the tumor mass to the surrounding tissue.
Classic change of facial features, increase the size of the hands and feet, jaw changes, macroglossia, voice changes are the most well-known manifestations of acromegaly, but appear relatively late and only a small
percentage of cases.
Reproductive disorders may be the first clinical manifestations of endocrine disease. Therefore, professionals managing these patients need to be informed about current screening and diagnostic algorithms, including
laboratory testing.
Algorithm of laboratory examinations for the early acromegaly diagnosis includes evaluation of insulin-like growth factor-1, growth hormone levels and oral glucose suppression test. Elevated levels of insulin-like growth
factor-1, the basal level of growth hormone more than 0.4 ng/ml, and the inability to suppress the secretion of growth hormone below 1 ng/ml (0.4 ng/ml as the proposed cut-off point if there are elevated levels of insulin-like
growth factor-1) in the glucose load test are the basis for biochemical diagnosis of acromegaly.
Topical diagnosis of the tumor (magnetic resonance imaging of the pituitary with and without contrast agent) and additional laboratory studies of hormonal status (determination of the level of prolactin to select further
tactics) are performed after the biochemical diagnosis of acromegaly.
Keywords: acromegaly, prolactin, growth hormone, insulin-like growth factor-1, infertility.

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