ETIOLOGICAL AND PATHOGENETIC ASPECTS OF ACROMEGALY IN PEDIATRIC PATIENTS
Keywords:
acromegaly, pediatric acromegaly, gigantism, growth hormone, insulin-like growth factor-1Abstract
Acromegaly in children is a rare endocrine disorder characterized by excessive
secretion of growth hormone (GH), usually caused by a pituitary adenoma. Unlike adults, excessive
growth hormone production in children often occurs before epiphyseal plate closure, resulting in
accelerated linear growth and gigantism. The disease is associated with elevated levels of insulinlike
growth factor-1 (IGF-1), which mediates many of the physiological and pathological effects of
growth hormone. Early diagnosis is challenging due to the gradual onset of symptoms and the rarity
of the condition. Understanding the etiology and pathogenesis of pediatric acromegaly is essential
for timely diagnosis, appropriate treatment, and prevention of long-term complications. This article
reviews the major etiological factors and pathogenic mechanisms involved in the development of
acromegaly in children.
References
1. Melmed S. Acromegaly pathogenesis and treatment. Journal of Clinical Investigation.
2020;130(7):3437–3445.
2. Katznelson L. Diagnosis and management of acromegaly. Endocrine Reviews. 2019;40(5):1205–
1235.
3. Melmed S, Bronstein MD, Chanson P, et al. A consensus on acromegaly management. Pituitary.
2018;21(1):1–12.
4. Colao A, Grasso LF, Pivonello R, et al. Acromegaly. Nature Reviews Disease Primers.
2019;5(1):1–17.
5. Giustina A, Chanson P, Kleinberg D, et al. Expert consensus on acromegaly diagnosis. European
Journal of Endocrinology. 2020;183(6):G1–G18.
6. Lindsay JR, Jonklaas J. Pediatric pituitary disorders. Endocrinology and Metabolism Clinics of
North America. 2018;47(2):257–274.
7. Beckers A, et al. Genetic aspects of pituitary adenomas. The Lancet Diabetes & Endocrinology.
2021;9(3):189–200.
8. Freda PU. Clinical review: Acromegaly in children and adolescents. Clinical Endocrinology.
2019;91(3):345–356.
9. Molitch ME. Pituitary tumors in childhood. Endocrine Practice. 2017;23(9):1135–1145.
10. World Health Organization (WHO). Endocrine Disorders: Clinical Guidelines. Geneva: WHO;
2023.
