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Endocrine Abstracts (2023) 90 P142 | DOI: 10.1530/endoabs.90.P142

ECE2023 Poster Presentations Pituitary and Neuroendocrinology (123 abstracts)

Characterization of a large cohort of patients with “micromegaly”: long-term follow-up and preliminary data on treatment response

Giulia Carosi 1,2 , Alessandra Mangone 1,3 , Elisa Sala 1 , Giulia Del Sindaco 1,3 , Roberta Mungari 1 , Arianna Cremaschi 1,3 , Emanuele Ferrante 1 , Maura Arosio 1,3 & Giovanna Mantovani 1,3


1Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Endocrinology Unit, Milano, Italy; 2Sapienza University of Rome, Department of Experimental Medicine, Roma, Italy; 3University of Milan, Department of Clinical Sciences and Community Health, Milan, Italy


Background: In a previous study, we retrospectively analysed a group of patients with high insulin growth factor 1 (IGF1) but normal growth hormone (GH) suppression, identifying among them a subgroup of “micromegalic” patients presenting with clinical features of acromegaly and high rate of comorbidities. We therefore expanded our cohort of patients, extended the follow-up time and collected preliminary data on treatment response aiming to better characterize this condition.

Patients and methods: We enrolled 86 patients (53 included in our previous study, mean age 48±17 years, 56 females and 30 males) referred to our Endocrinology Unit between 2008 and 2022, presenting with persistently high IGF1 and adequate GH nadir after glucose load (<0.4 ng/ml according to most recent guidelines). We divided them in two groups: with (G1, “micromegaly”, n=28/86) or without (G2, 58/86) clinical features of acromegaly. We performed systematic clinical-instrumental screening of acromegaly-related comorbidities (arterial blood pressure and glucose metabolism evaluation, thyroid ultrasound for goitre, colonoscopy and/or faecal occult blood for colonic polyposis, echocardiography for cardiopathy, polysomnography and ESS questionnaire for OSAS). We recorded biochemical and clinical data from diagnosis to the last available follow-up. Finally, we collected preliminary data of a small subgroup of patients who underwent medical or surgical treatment.

Results: In G1 group (“micromegaly”) we confirmed a higher prevalence of comorbidities vs G2 (median comorbidities for each patient 4 vs 3, P=0.001), especially goitre (P=0.009), carpal tunnel (P=0.003) and malignant neoplasms (P=0.03). During a mean follow-up time of 6±3 years, IGF1 and GH nadir levels did not significantly change, whilst we observed an increase in random GH values in G1 vs G2 patients (P=0.03). Four patients with highly suggestive clinical features of acromegaly and typical comorbidities were selected for treatment: two were treated with somatostatin analogues and two underwent transsphenoidal surgery (1 micro and 1 macroadenoma, both histologically proven GH+). All treated patients showed normalization of IGF1 values and referred subjective improvement in clinical symptoms.

Conclusions: Our preliminary data suggest that “micromegalic” patients present typical comorbidities of acromegaly and can benefit from either medical or surgical therapy.

Volume 90

25th European Congress of Endocrinology

Istanbul, Turkey
13 May 2023 - 16 May 2023

European Society of Endocrinology 

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