Endocrine Abstracts

Acromegaly is a rare disease. In more than 99% of cases this is due to a benign pituitary growth-hormone secreting adenoma. This leads to changes in appearance, enlargement of the internal organs and, after a long period of time, to multiple comorbidities.

Objectives

To determine which factors might have contributed to the lower quality of life in three acromegalic patients.

Materials and methods

The patients completed a Romanian translation of Acromegaly Quality of Life Questionnaire (AcroQol) in two separate occasion, while they were re-evaluated in our clinic. All the other data were collected retrospectively, form their medical files. All three patients are female. Patient 1, aged 68 years old, was diagnosed and treated for a pituitary macroadenoma in 2013 by neurosurgery. Patient 2, aged 59 years old, was diagnosed in 2001 and was treated twice by neurosurgery (2003 and 2004) and in 2004 with Gamma Knife. Patient 3, aged 70 years old, was diagnosed with a mixt pituitary microadenoma, secreting GH and PRL, in 2001 and was treated with a dopamine agonist until 2013, when she underwent neurosurgery. All three patients are currently under treatment with a somatostatin analogue and have varying degrees of hypopituitarism for which they receive substitution therapy. Patient 2 and 3 have controlled disease and Patient 1 has partially controlled disease. Patient 1 and 3 are obese and have more than 3 comorbidities associated with acromegaly, including psychiatric disorders. AcroQoL is a disease-specific, self-administered questionnaire to asses quality of life in people diagnosed with acromegaly. It contains 22 items, divided into two scales, one evaluating physical and the other, psychological aspects (also divided in two sub-dimensions-physical appearance and personal relationships). The score varies between 0 (worst HRQol) and 100 (best HRQol).

Results and discussions

Patient 1 had a total score of 27.27 in 2017 and 48.86 in 2020. Patient 2 had a total score of 38.36 in 2017 and 56 in 2019. Patient 3 had a total score of 38.36 in 2017 and 45.45 in 2020. All three patients had the lowest score in the appearance sub-domain at the first presentation. Patient 1 had the lowest score in personal relationship sub-domain at the second re-evaluation. At the last evaluation Patient 3 had the lowest global score, while at the first presentation Patient 1 had the lowest score. In conclusions, for all these three patients the control of acromegaly improved quality of life.