Jasper et al used a clinical score to monitor disease activity in patients with acromegaly. This can be useful at diagnosis and to monitor the patient's response to therapeutic interventions. The authors are from Ricardo Gutierrez Children's Hospital and Santa Lucia Hospital in Buenos Aires, Argentina.


All patients had undergone treatment. All had surgery with confirmation of a pituitary tumor. Some patients received radiation and/or medications.



(1) body weight

(2) blood pressure

(3) headaches

(4) facial features

(5) tongue size

(6) perspiration (hyperhidrosis)

(7) shoe size

(8) ring size (finger)

(9) galactorrhea

(10) acroparesthesias

(11) arthritic complaints (degenerative arthritis)

(12) fibroma molluscum

(13) goiter

(14) cardiomegaly

(15) hepatomegaly

Change After Surgery






no change


got worse



total score for signs and symptoms =

= SUM(points for all 15 items)


clinical activity score =

= MEAN(score) =

= (total score for signs and symptoms) / 15



• minimum score: 1

• maximum score: 4

• A score < 2 is associated with inactive disease.


Observations on IGF-I, IGFBP3 (IGF binding protein-3) and the ratio of IGF-I to IGFBP3 for the diagnosis and monitoring of acromegaly:

• IGF-I is useful for diagnosis and monitoring of a patient with acromegaly. It is preferable since it is more biologically meaningful. An increase in IGF-I causes many of the systemic effects of acromegaly, and a change during patient monitoring indicates a comparable change in clinical activity.

• IGFBP3 is a useful marker for diagnosing and monitoring a patient with acromegaly.

• The molar ratio of IGF-1 to IGFBP3 was not better in detecting disease activity.


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