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Recognizing the clinical manifestations of acromegaly: Case studies.
MedLine Citation:
PMID:  24170330     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To present case studies of a 36-year-old woman and a 73-year-old man who presented with the syndrome of acromegaly, and to provide primary care nurse practitioners (NPs) with the understanding of the clinical and laboratory features needed for early recognition and treatment of this fascinating disease.
DATA SOURCES: A comprehensive review of published literature on acromegaly is presented. The findings discussed include the history, physical examination, and diagnostic studies of two patients presenting in different ways. They both saw multiple healthcare providers, and had symptoms and signs eventually leading to the diagnosis of acromegaly.
CONCLUSIONS: Acromegaly is the result of excessive amounts of growth hormone (GH) and insulin-like growth factor type 1 (IGF-1), almost always caused by a benign adenoma of the pituitary gland. This leads to coarse facial features, soft tissue swelling (including the tongue), enlargement of the hands and feet, respiratory problems, hypertension, diabetes mellitus, carpal tunnel syndrome, and osteoarthritis. Early recognition and appropriate referral can reverse some of the signs and symptoms over time, and lead to decreased mortality and a markedly improved quality of life.
IMPLICATIONS FOR PRACTICE: These cases exemplify the challenges faced by NPs and other healthcare providers in diagnosing patients with acromegaly.
Authors:
Sherry L Iuliano; Edward R Laws
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-8-27
Journal Detail:
Title:  Journal of the American Association of Nurse Practitioners     Volume:  -     ISSN:  2327-6924     ISO Abbreviation:  J Am Assoc Nurse Pract     Publication Date:  2013 Aug 
Date Detail:
Created Date:  2013-10-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101600770     Medline TA:  J Am Assoc Nurse Pract     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
©2013 The Author(s) ©2013 American Association of Nurse Practitioners.
Affiliation:
Department of Neurosurgery, Pituitary/Neuroendocrine Center, Brigham & Women's Hospital, Boston, Massachusetts.
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