ECE2021 Eposter Presentations Pituitary and Neuroendocrinology (32 abstracts)
Acromegaly in the elderly: about 3 cases
Ajili Rihab , Yosra Hasni , Gorchene Asma , Ben Abdelkarim Asma , Ghada Saad , Maha Kacem , Molka Chadli Chaieb , Amel Maaroufi & Koussay El Euch
Farhat Hached Sousse, Endocrinology, Sousse, Tunisia
Introduction
Somatotropic adenomas in the elderly are rare, and characterized by diagnostic delay and non-specific clinical signs. We report three cases of acromegaly discovered at a late age.
Observation
They are three women aged 66, 68 and 77 respectively. The circumstance of discovery of acromegaly was goiter in the first case (P1), poorly controlled diabetes in the second case (P2) and dysmorphic syndrome in the third case (P3). The level of IGF1 was respectively for P1 and P2, 1084 ng/ml and 1700 ng/ml. P1 had hyperprolactinemia with gonadotropic insufficiency. The pituitary axis was intact for P2 while P3 had panhypopituitarism. All the patients were diabetic and had joint involvement. P1 and P3 were hypertensive with left ventricular hypertrophy. It was a macroadenoma with invasion of the optic chiasm in all three cases. P1 presents with progressive acromegaly despite surgery twice with a preparation with somatostatin analogues. P2 was cured by the combination of surgery, radiotherapy and somatostatin analogues while P3 was lost to follow-up after surgery.
Discussion and conclusion
Acromegaly in the elderly is frequently associated with diabetes and hypertension. Surgery remains the treatment of choice. If it is contraindicated in the face of fragile conditions in the elderly, treatment with somatostatin analogues should be considered as a first-line treatment. The prognosis of acromegalic patients is inversely correlated with the patient’s age.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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