Endocrine Abstracts

Background: Acromegaly is a relatively rare endocrine disorder which may result in morbidity and mortality. In this study, we report the demographical and clinical characteristics of 62 acromegalic patients who were followed-up at our Department of Endocrinology Clinic.

Methods and results: In this retro-prospective study, medical files of the patients who were followed-up from 1984 to 2013 were examined. Data was obtained for age at the time of diagnosis, gender, time period to the initial diagnosis, follow-up period, levels of GH and IGF1, hyperprolactinemia, tumor size, treatment methods. SPSS-19 version was used for statistical analysis.

There were 62 patients (30 males and 32 females). Mean age at the time of diagnosis was 38.81±1.4 and mean period to diagnosis 4.5±0.3 years. Microadenoma was detected in 8 (12.9%) and macroadenoma in 53 (85.5%) of the patients. Tumor sizes were <10 mm in 8 (12.5%), 10–20 mm in 16 (25.8%) and >20 mm in 31 (50%). GH levels were significantly correlated with the initial tumor size (P=0.002). Initial GH levels were >2.5 ng/ml; mean of IGF1 levels was found 993.5±79. Fifty patients were examined for visual field and 16 (%32) were found to be defective. The surgical method and the tumor size did not show significant correlation (P=0.079). Twenty-seven (43.5%) patients were operated transsphenoidally, 20 (32.3%) patients transcranially. Forty (64.5%) patients were operated once, 7 (11.3%) twice, 2 (3.2%) three times, 1(1.7%) seven times. Thirteen (21%) patients had hyperprolactinemia. Most common symptoms were growth of hands and feet with the facial signs (75.8%). Diabetes mellitus was present in 22 (35%) patients, hypertension in 13 (20.9%), carpal tunnel syndrome in 2 (3.2%). Five (8.1%) patients had conventional radiotherapy. Gamma-knife radiotherapy was applied to 15 (24%) patients. Primary pharmacotherapy was given to 6 (9.6%) patients. Ocreotid LAR was initiated to 52 (84%) patients and lanreotid to 5 (8%) patients during follow-up period after surgery.

Conclusion: Since the diagnosis of our patients were late, the rates of macroadenoma, GH levels, IGF1 levels, visual defect and diabetes mellitus were high. Therefore the number of patients who required radiotherapy and pharmacotherapy postoperatively was high as well. The most important reason of this is that the diagnosis of acromegaly is not considered before the beginning of the clinical symptoms and findings and the consequent late diagnosis.