Editorial QJM Modern management of acromegaly

Acromegaly is a rare disease, about 5 new patients/ million population being diagnosed each year. The cause is almost always a benign adenoma of the somatotroph cells of the pituitary, exceptionally the ectopic production of growth hormone releasing factor or growth hormone itself being implicated. Rarely, acromegaly is familial, with or without other endocrine tumours (e.g. parathyroid and pancreatic islets), as in multiple endocrine neoplasia Type 1. The characteristic signs of acral expansion in acromegaly are easily recognized by the trained observer, but because of their insidious onset and gradual progression may go unrecognized for many years by patients and their close relatives. Herein lies one of the major unknowns; what damage