Endocrine Abstracts

Introduction: Acromegaly is a rare disorder caused by excessive growth hormone production. Common clinical manifestations are visual changes as well as serious systemic complications. In childhood and adolescence, excessive growth hormone production leads to abnormal tall stature. To date, only a few studies have been published focusing on analysing the growth of patients with acromegaly, in particular regarding the growth of their parents and siblings. A single report (Perheentupa et al. 1986) suggested, that acromegalic patients came from high-growth families. The aim of this study is to test the relationship between the tall stature related to midparental height (MPH) and clinical features, the onset of diagnosis and comorbidities.

Methods: This is a pilot, one centre cohort study conducted in 2019 among adult acromegalic patients with no family history of pituitary adenoma. Patients were analysed in 2 subgroups depending on body height: normal stature and tall stature defined as body height above 97 percentile for sex, age, and ethnicity or >1.5 standard deviation (s.d.) from MPH. The structural anamnesis including e.g. data on parents/siblings/patient’s body height was collected during a routine outpatient clinic visit.

Results: Among 100 consecutivepatients interviewed in the outpatient clinic, full data were available from 26 males (43%) and 34 females (57%) with a mean age at the diagnosis 46 years (19–75). Retrospectively 14 patients (23%) presented features of acrogigantism: 15% met criteria of gigantism, whereas 8% presented tall stature. Acrogigantism patients were significantly younger (33.64 ± 10.74 vs 50.24 ± 14.15 years) with concomitant hypogonadism (64.29 vs 26.83%), greater tumour size (21 vs 12 mm) and higher growth hormone concentration (62.5 vs 21.8 uIU/ml) in comparison to normal stature patients (<0.05). In acromegalic patients with normal stature father’s height (–0.37 ± 0.97 s.d.) and mother’s height (–0.82 ± 0.96 s.d.) were smaller in comparison to the polish population mean (P < 0.05). Only female siblings’ height in both groups and mother’s height in tall stature group were above the polish population mean but not statistically significant.

Conclusion: According to our results, the higher stature of patients with sporadic somatotropinoma might be due to pre-existing unrecognized gigantism in adolescence and it is not associated with primary genetic tallness. Midparental hight is an important predictive parameter in a late diagnosis of acrogigantism.