Endocrine Abstracts

Introduction: Thyroid diseases are frequent in acromegalic patients. We aimed to investigate thyroid function and morphology in a population of patients with de novo acromegaly.

Materials and methods: We evaluated 32 patients newly diagnosed with acromegaly in a single medical center. We collected data on patient’s age, sex, duration of acromegaly symptoms, history of thyroid disease, laboratory tests results (serum GH, IGF1, TSH, fT4, fT3, and antithyroid antibodies), thyroid ultrasound (US), and fine-needle aspiration biopsy (FNAB) results and treatment applied in patients with thyroid diseases.

Results: In the studied group of 17 female and 15 male acromegalic patients with mean age of 51.3±12.7 years and mean disease duration of 10.4±5.4 years, thyroid disorders were found in 27 cases (84.4%). Eighteen patients were diagnosed with thyroid disease on admission and nine patients had a history of thyroid disease and prior treatment (among them two had thyroidectomies: one for papillary carcinoma and one for multinodular goiter (MNG); two patients were treated with thiamazole for toxic MNG and 1 with L-thyroxine for autoimmune hypothyroidism). Together, 14 individuals (43.8%) had thyroid dysfunction: 8 (25%) subclinical and 3 (9.4%) overt hyperthyroidism and 3 patients (9.4%) hypothyroidism. Median thyroid gland volume was 30.81 ml (range: 10.4–191.4) and we found enlarged thyroid gland in 12 women (80%) and in 9 men (64.3%). MNG was the most frequent US finding (n=20, 66.7%). FNAB was performed in 14 patients. In one male patient a new papillary carcinoma was diagnosed and subsequently he was treated with thyroidectomy and radioiodine ablation. Nine patients underwent radioactive iodine treatment.

Conclusion: We found a high frequency of thyroid dysfunction especially subclinical hyperthyroidism and high prevalence of nodular thyroid disorder in a population of naïve active acromegalics. We suggest routine screening for thyroid diseases in all patients with newly diagnosed acromegaly.