XXXX : unravelling a complex disease.

@entity1 @entity2338 @entity2163 @entity442 @entity4611 @entity2012 @entity4614 @entity652 @entity65 @entity4903
@entity2012 is a @entity4903 characterized by growth hormone hypersecretion and is usually caused by a @entity4611 . It is associated with significantly increased @entity1 morbidity and mortality. Molecular biological studies have implicated a causative role for oncogenic mutations (activating @entity2163 mutations and/or chromosomal 11q13 deletions) in less than 50% of cases. The cause(s) in the remaining 50% is speculative. Epidemiological evidence indicates that biochemical cure is achieved when mean GH levels are 5mU/l or less during a day-profile. This GH value correlates well with that required to normalize the serum @entity442 concentration, a GH-dependent peptide which can be used to monitor the disease activity in @entity2012 . Treatment must be carried out under the supervision of a dedicated endocrinologist and tailored to @entity1 needs. The success of any treatment modality (surgery/pituitary irradiation/medical) depends on @entity652 size and the extent of pretreatment GH hypersecretion. A combination of therapies is usually required to achieve satisfactory control of @entity652 and GH hypersecretion. Octreotide, a synthetic analogue of native somatostatin, is particularly effective in controlling GH hypersecretion in this condition and the widespread introduction of a long-acting depot preparation is eagerly awaited. The development of @entity2338 as a result of treatment is potentially worrying in view of its possible contribution to the increased incidence of @entity65 associated with @entity4614 .
