ACROMEGALY Case Series: Thirty Years Clinical Experience at the University Hospital of Puerto Rico
Allende-Vigo, M.; Alvarez-Valentín, D.; Torres-García, E.; Ruiz-Bermúdez, O.; López-Valentín, M.
Boletin de la Asociacion Medica de Puerto Rico 109(1): 13-20
2017
ISSN/ISBN: 0004-4849 Document Number: 703063
INTRODUCTION: Acromegaly is a rare disease markedly affecting a patient's life due to its morbidity and mortality. The aim of this study was to review the presentation, therapeutic outcomes, as well as clinical characteristics and comorbidities in the case series of Acromegaly attending a single center in the past 30 years. METHODS: A retrospective chart review. RESULTS: Data of 33 patients (66.7% women) was reviewed: the mean age of diagnosis was 42.6 years and diagnostic delay was estimated in 4.2 years. The mean insulin growth factor-1 (IGF-1) and growth hormone (GH) at diagnosis were 978.4±344.5 ìg/L and 31.2±26.1 ìg/L, respectively. Pituitary imaging showed macroadenoma in 80.8%, and microadenoma in 19.2%. Hypertension, obesity, osteoarthritis, dyslipidemia and diabetes were the most frequent comorbidities. The first treatment option, in 71.9% of the cases was neurosurgery (NS), drugs in 15.6% and radiotherapy (RT) in 12.5% of subjects. Subjects were cured in 25.0% of the cases treated with NS. The rate of adequate postoperative cure in macro- and micro-adenoma were 20.0% and 50.0%, respectively. Hypopituitarism occurred in 37.5% of subjects. Patients treated with RT and NS developed deficiency of one or more pituitary hormones in 61.5% and 13% of cases, respectively. Of 10 patients who underwent colonoscopy, 7 had colonic polyps. CONCLUSION: This series suggests that long-term excessive growth hormone secretion favors development of complications. Our low rate of cure or control of the disease points towards the need for improvement of current treatment strategies.
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