Endocrine Abstracts

Introduction: Acromegaly results from an autonomous hypersecretion of growth hormone (GH) typically by a pituitary adenoma, commonly revealed by a dysmorphic syndrome. The aim of our study was to describe clinico-biological and radiological features of acromegaly.

Methods: We conducted a retrospective study including 28 patients with acromegaly followed in the endocrinology department of Charles Nicolle Hospital. Clinical, biochemical, ophthalmological and imaging data were extracted from medical records.

Results: The mean age of our patients was 45,9 ± 13,9 with a sex ratio (F/M) of 1.5. Dysmorphic features, obesity, high blood pressure, electrical left ventricular hypertrophy, hepatomegaly, goiter and Galactorrhea were found in 96, 50, 61, 29, 25, 41 and 26% of cases, respectively. Obstructive sleep apnea was detected in 57% of patients. Pituitary evaluation showed corticotrop (41%), thyrotropin (19%) and gonadotropin deficiencies (67%). Disconnection hyperprolactinemia and cosecretion of prolactin were found in 33 and 4% of cases, respectively. Metabolic complications included diabetes (43%), prediabetes (36%), hypertriglyceridemia (57%), hypercholesterolemia (39%), low HDL-cholesterol level (73%), hypercalcemia (11%), hyperphosphoremia (29%) and hypercalciuria (22%). The median (IQR) GH was 24 (8-50) ng/ml. The mean size of adenomas was 20.4 mm [extremes :7mm-38mm]. Aggressive macroadenomas were detected in 14% of cases. Adenomas were invading optic chiasm (37%), cavernous sinus (30%) and sphenoidal sinus (11%). Tumor size was positively correlated with GH level (r=0.731, P< 10-3) and negatively correlated with age (r=-0.387, P=0.042). Patients with aggressive adenomas were younger (P=0.028) and had lower cortisol levels (P=0.002).

Conclusion: The morbimortality of acromegaly is aggravated by its cardiovascular, respiratory, metabolic and ophthalmological complications that worsen the global prognosis.