Navegando por Palavras-chave "acromegaly"
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- ItemAcesso aberto (Open Access)Adenomas produtores de GH: Análise de 20 casos(Academia Brasileira de Neurologia - ABNEURO, 2002-03-01) Tella Jr, Oswaldo Inácio de [UNIFESP]; Herculano, Marco Antonio; Delcelo, Rosana [UNIFESP]; Aguiar, Paulo Henrique; Universidade Federal de São Paulo (UNIFESP); Faculdade de Medicina de Jundiaí Disciplina de Neurocirurgia; Universidade de São Paulo (USP)The growth hormone secreting pituitary adenomas can be mono, bi or pluri-hormonals. The most frequent association of GH is with the sub unit alpha or with the prolactin. This type of adenoma comes with the classic alterations of acromegaly, but when they produce more than one hormone, visual symptoms can be present. The adenoma producing just GH hormone is generally microadenoma and the other two groups tend to be macroadenoma. We analyze 20 cases of these adenomas and we have found quite satisfactory surgical result for the mono-hormonal type group. Radiotherapy should be considered in cases of partial resection.
- ItemAcesso aberto (Open Access)Controle hormonal dos adenomas hipofisários pela cirurgia transesfenoidal: evolução dos resultados nos primeiros cinco anos de experiência(Sociedade Brasileira de Endocrinologia e Metabologia, 2011-02-01) Barbosa, Erika Ribeiro [UNIFESP]; Zymberg, Samuel Tau [UNIFESP]; Santos, Rodrigo de Paula [UNIFESP]; Machado, Helio Rubens; Abucham, Julio [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)OBJECTIVE: To evaluate the initial results of a surgical team in the hormonal control of secreting pituitary adenomas. MATERIALS AND METHODS: In five years 51 functioning adenomas were operated (31 GH-secreting, 14 ACTH-secreting, 5 PRL-secreting and 1 TSH-secreting). Hormonal control was defined as GH < 2,5 ng/mL, normal free-urinary cortisol, lower prolactin and normal T3 and FT4. RESULTS: Control rates were 36% in acromegaly, and 57% in Cushing's disease. Two prolactinomas normalized prolactin levels. Thyroid hormone levels were normalized in the TSH-secreting adenoma. Control of hypercortisolism was positively correlated with years of experience (p = 0.01). CONCLUSION: Our results, although restricted to the beginning of our experience, lie below the reported range of other surgical series with much longer experience. During these years, there was a significant improvement in initial post surgery urinary cortisol levels in Cushing's disease as a function of surgical experience.
- ItemSomente MetadadadosOsteopenia occurs in a minority of patients with acromegaly and is predominant in the spine(Springer, 1997-01-01) Kayath, M. J.; Vieira, JGH; Universidade Federal de São Paulo (UNIFESP)Acromegaly may induce abnormalities in bone metabolism; however, there are limited data related to bone mineral density (BMT)) in this condition. To evaluate the effects of an excess of growth hormone/insulin-like growth fractor I(GH/IGF-I) in the skeleton, we measured the BMD in spine and femoral region, total body calcium and body composition in 45 patients (24 females and 21 males) aged 21-77 years (median 43 years) with acromegaly for 11.4 +/- 7.5 years (range 0.5-26 years) using a dual-energy X-ray absorptiometer (Lunar DPX). Thirty-four patients had had hypogonadism fur 8.6 +/- 6.5 years (1-24 years). Mean serum GH and IGF-I levels were respectively 159 +/- 183 mu g/l and 843 +/- 497 mu g/l. Total body calcium was increased in the acromegalics (males: 1272 +/- 217 g, range 916-1816 g; females: 1041 +/- 223 g,range 739-1609 g)when compared with normal individuals (males: 1115 +/- 144 g, range 856-1398 g; females: 909 +/- 144 g, range 511-1311 g; p = 0.01). the lean body mass was significantly higher in acromegalic patients (p<0.001) compared with normal individuals. There was a tendency for a lower fat percentage in the acromegalics; however, this difference was not significant. Osteopenia (I Z-score below the mean) was found in the spine in 20% (n = 9) of the patients, while BMD was decreased in the femoral region in only 8.8% (n = 4). the group with osteopenia had a greater duration of hypogonadism than the normal BMD group (14 +/- 11 years vs 4.4 +/- 4.0 years;p = 0.01). A negative correlation was also found between the duration of hypogonadism and BMT) in spine (r = -0.4; p = 0.003) and femoral region (r = -0.37; p = 0.013), the hypogonadal patients had a lower BMD in spine (p<0.005), but not in other regions analyzed. No correlation was found between duration of hypersomatotropism, GH/IGF-I levels and BMD. We conclude that the majority of patients with acromegaly have preserved BMD despite the presence of hypogonadism.
- ItemSomente MetadadadosPituitary Apoplexy After a Single Dose of Long-Acting Octreotide(Lippincott Williams & Wilkins, 2010-01-01) Chang, Claudia Veiga; Felicio, Andre Carvalho [UNIFESP]; Nunes, Vania dos Santos; Carneiro da Cunha-Neto, Malebranche Berardo; Barros de Castro, Ana Valeria; Univ Estadual Paulista; Universidade de São Paulo (USP); Universidade Federal de São Paulo (UNIFESP)Pituitary apoplexy (PA) is a rare and potentially life-threatening syndrome resulting from an acute infarction or hemorrhage of the pituitary gland. Although the pathogenesis is not fully understood, some predisposing factors such as pituitary stimulation tests, diabetes mellitus, anticoagulant or antiplatelet aggregation therapy, head trauma, and high blood pressure may play a role in its pathophysiology. Octreotide is the mainstay of medical treatment for acromegaly. the majority of reported complications of octreotide therapy are gastrointestinal. We report the case of a 51-year-old acromegalic woman who developed pituitary apoplexy within the context of high blood pressure and a single dose of long-acting octreotide. Our data suggest that the combination of hypertension and octreotide therapy enhances the risk of pituitary apoplexy.