Endocrine Abstracts

Introduction: The osteoarticular complications of acromegaly are among most disabling impacts, and can be explained by two mechanisms, chronic exposure to high levels of GH and IGF1 leading to increased bone turnover, hypertrophy and osteocartilaginous degeneration, as well as the gonadal insufficiency observed during acromegaly may aggravate the situation. The objective of this study is to describe the rheumatological manifestations of acromegaly.

Materials and methods: This is a descriptive study of 25 patients followed up in the endocrinology, diabetology and nutrition department of the Mohammed VI University Hospital center in Oujda. All patients had a complete clinical examination, a phosphocalcic assessment and a bone densitometry.

Results: The mean age was 49.1±14.4 years (24-71) with a sex ratio (M/F) of 1.08. The mean age of the diagnostic disease was 71 years and the mean IGF-1 level was 706.5± 257.8 ng/mL. Peripheral articulation manifestations included diffuse arthralgias and acromegalic arthropathy, which were present in 69.6% and 28.6% of the cases respectively. Axial affection was dominated by spinal pain, which was present in 30.4% of cases, accompanied by scoliosis and cervical hyperlordosis in 16% and 48% respectively, and vertebral fractures were found in 13% of cases. Neuromuscular manifestations with carpal tunnel syndrome were reported in only one patient. The evaluation of the phosphocalcic assessment finds vitamin D deficiency in 83% of cases. Bone densitometry showed osteoporosis in 16.7%, osteopenia in 44.4% of patients.

Discussion - Conclusion: The rheumatological complications of acromegaly are the principal causes of functional incapacity, hence the interest in seeking them out early in order to reduce their impact on the functional prognosis. Our results confirm the frequency of these manifestations detected at the time of diagnosis or follow-up of acromegaly, underlining the need for a multidisciplinary approach in order to improve the quality of life of patients.