Introduction

The diagnosis of acromegaly is clinical, biochemical, and anatomic. The clinical diagnosis involves a suspicion of excessive growth hormone (GH) production when the patient has symptoms such as changes in facial features, enlargement of hands and feet, excessive sweating, dental malocclusion, sleep apnea, hypertension, diabetes mellitus, colon polyps, and skin tags. Unfortunately, the majority of patients with acromegaly have symptoms of the disease for 7 to 8 yr before the diagnosis is ascertained. Untreated acromegaly results in premature mortality, most commonly from cardiovascular disease (1-6). Thus, prompt diagnosis and treatment are essential to reduce the risk of morbidity and premature mortality; reduction in GH production to normal reduces this risk of premature death (7).

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