Consensus on criteria for acromegaly diagnosis and remission

In a patient with typical acromegaly features, IGF-I > 1.3 times the upper limit of normal for age confirms the diagnosis

Random growth hormone (GH) after overnight fasting may be useful for informing prognosis, but is not required for diagnosis

For equivocal results, IGF-I can be repeated using the same validated assay; oral glucose tolerance testing might also be useful

Biochemical remission is the primary assessment of treatment outcome, but biochemical findings should be interpreted within the clinical context of acromegaly

Follow up should consider biochemical evaluation of treatment effectiveness, imaging of residual/recurrent adenoma mass, and clinical signs and symptoms of acromegaly, its complications and comorbidities

Referral to a multidisciplinary pituitary center should be considered for equivocal biochemical, pathology or imaging findings at diagnosis, and for patients insufficiently responsive to standard treatment