Endocrine Abstracts

Introduction: Acromegaly is a rare pathology characterized by chronic hypersecretion of Growth Hormone (GH) and Insulin-like Growth Factor-1 (IGF-1) that causes somatic, metabolic, and systemic changes. There are few data in the literature on the impact of the disease in male.

Patients and methods: Retrospective descriptive study including 15 adult males with acromegaly hospitalized in the endocrinology department of the Hedi Chaker Sfax university hospital over the period from 1998 to 2020. Acromegaly was diagnosed at an average age of 46.6 years with a peak incidence between the ages of 40 and 59 years. Acromegaly was revealed at an age beyond 60 years in 3 patients (20%). The diagnosis time was, on the average of 7.2 years ±6.1 with extremes ranging from 2 days to 17 years. Acrofacial dysmorphic syndrome was the most common discovery circumstance (53.3% of cases, n=8). Two patients among these 8 were diagnosed with diabetes mellitus during follow-up (13.3%). The tumor mass syndrome was the revealing symptom of the adenoma in 5 cases (33.3%) and antepituitary insufficiency was the revealing symptom in 2 cases. Decreased libido and erectile dysfunction were reported during the interview by 33.3% and 26.6% of patients respectively. Joint manifestations were found in 7 patients (46.6%) such as paresthesias in 4 patients (26.6%) and carpal tunnel syndrome in 3 patients (20%). Hypertension was observed in 5 patients (33.3%) and hypertrophic cardiomyopathy in 3 patients (20%). Sleep apnea syndrome (SAS) was diagnosed in 4 patients (26.6%). A homogeneous multinodular euthyroid goiter was observed in 2 patients (20%). Digestive colonoscopy showed colonic polyps in 2 patients (20%). One patient had segmental and focal hyalinosis and one patient had Wolf Parkinson’s white syndrome. A gonadotropic deficiency was noted in 26.6% of patients (n=4), a thyrotropic deficiency in the same percentage and a corticotropic deficiency in 13.3% of patients (n=2). Carbohydrate tolerance disorders were noted in 7 patients (46.6%): prediabetes in 2 cases (13.3%) and diabetes in 5 cases (33.3%). Macroadenomas were the most common (73.3%). However, We did not detect giant somatotropic adenomas.

Conclusion: Production of GH has deleterious effects on many aspects of male sexuality. It induces hypogonadism through mass effect and through increase of prolactinemia. Moreover, hypogonadism is also one of the factors linking acromegaly to erectile dysfunction (ED), and metabolic complications of acromegaly.