ECE2023 Poster Presentations Pituitary and Neuroendocrinology (123 abstracts)
Epidemiology, clinical presentation, treatment and outcome of acromegaly in the island of Crete, Greece. 27 years of follow up study
Maria Chrysoulaki 1,2 , Stavrina Vergou 1 , Artemis Maria Makri 1 , Elpida Mpouhlaki 1 , Stefanos Michailidis 1 , Vasiliki DARAKI 1,2 , Maria Sfakiotaki 2 , Grigoria betsi 1,2 , Kalliopi Kontolaimaki 1,2 , Rodanthi Vamvoukaki 1,2 , Dimitra Sifaki-Pistola 1 , Christos Lionis 1 , Georgios Goulielmos 1 & Paraskevi Xekouki 1,2
1University of Crete, School of Medicine, Heraklion, Greece; 2University General Hospital of Heraklion, Endocrinology & Diabetes Clinic, Iraklio, Greece
Background: Acromegaly is a rare endocrine disorder due to growth hormone excess attributed to a pituitary tumor, in most cases. Epidemiological data of acromegaly are derived from national tumor registries or population studies while there are no published data in the Greek population except for a few small studies regarding treatment outcome.
Methods: We carried out a retrospective ongoing observational study to determine the epidemiology, presentation and outcome in patients with acromegaly in University Hospital of Heraklion, Crete, Greece, referal center for acromegaly, from years 1995 to 2022. Age at diagnosis, estimated delay in diagnosis, clinical, biochemical and imaging data at presentation and post treatment were recorded.
Results: Forty-two patients were included in the analysis (28 females, 14 males). The mean age at diagnosis was 45.5 ±17 years and the mean follow-up time was 12,5± 14 years. Nine patients (21.4%) presented before the age of 30 years. The time lag from the onset of symptoms to diagnosis was 5,2 years. The three most common clinical features at diagnosis were acral changes (88%), coarse facial features (75%), headache(47,5%,). Nine patients (21.4%) had a microadenoma while 24 (57.1.%) harbored a pituitary macroadenoma. No size data were available for 21.5% patients. In our series, 10 patients (23.8% ) had a family history of pituitary adenoma including a family with Familial Isolated pituitary adenoma (FIPA) due to AIP mutation. Musculoskeletal manifestations were present in 46.4%, diabetes mellitus in 26.8% and hypertension in 16%. Fifteen patients (36.5%) declined surgery and were given medical treatment (somatostatin analogues in 31,7%, dopamine agonist in 2.4%, and combination therapy in 2,4%). Twenty seven patients (63,5%) underwent transsphenoidal surgery (TSS); two of them (5.4%) had a second surgery, Six patients (14.6%) received radiotherapy. Histology was available for 11 patients; densely granulated tumors were 1,7 times more frequent than sparsely granulated (26.3 vs 15.7%), whereas 10,4% were mixed mamosomatotrophs. There was one case of mixed gangliocytoma/sparsely-granulated somatotrophinoma. Disease remission was obtained in 14 patients (34%) and almost 50% had stable disease. The mean time interval from start of treatment till achievement of biochemical control was approximately 2 years. Seven patients (16%) remained biochemicaly uncontroled.
Conclusions: This is the first epidemiological study for acromegaly in Greece. Our results are similar to those of other international reports. We also confirm the data, of international registries that almost a third of all patients remain undertreated which underlies the importance for a better management.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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