Endocrine Abstracts

Introduction: Acromegaly is a chronic disease caused by GH hypersecretion resulting in increased IGF1 levels. The actions of these hormones result into a broad spectrum of clinical manifestations.

Objective: To evaluate clinical and analytical parameters, imaging, and treatment outcome in a population of acromegalic patients.

Methods: Retrospective study of acromegalic patients diagnosed between 1982 and 2011. Results are presented as mean±S.D.

Results: We included 98 patients (68 women) with a mean age at diagnosis of 45.4±14.6 years and a diagnostic delay of 6.8±5.3 years. Acral enlargement was the chief complaint (24.5%), followed by headache (18.4%) and maxillofacial changes (14.2%). The most common comorbidities were hypertension (36.7%), carpal tunnel syndrome (34.7%), sleep apnea (26.5%), thyroid nodules (25.5%), impaired glucose tolerance (22.4%) and diabetes (17.3%). Most women (68.6%) reported menstrual disturbances. The majority of tumors were macroadenomas (77.6%) at the time of diagnosis and 36.7% secreted both prolactin and GH. The mean basal GH at diagnosis was 28.5 ng/ml and mean nadir GH achieved during OGTT was 20.8 ng/ml. Gonadotropins deficit was the most common deficit (15 patients), two patients had pan-hypopituitarism, two had combined TSH and gonadotropins deficit and one TSH isolated deficit. The majority of patients (90.8%) were submitted to surgery, mainly by transsphenoidal approach, and cure (biochemical normalization and no recurrence during follow-up) was achieved in 37.1% patients.

Discussion: Although several studies suggest that acromegaly is diagnosed in approximately equal numbers of men and women, in this population there was a higher prevalence of the disease in women, which may reflect a greater concern with body image. The mean age at diagnosis, clinical manifestations and tumor size are similar to those described in other epidemiological studies. We consider a cure rate acceptable considering criteria applied.