Subclinical acromegaly: to treat or not to treat?

Endocrine journal

article

Ilan Shimon¹  Zaina Adnan³  Dania Hirsch¹  Hadar Duskin-Bitan¹  Amit Akirov¹ 

[1] Institute of Endocrinology, Rabin Medical Center - Beilinson Hospital;Sackler School of Medicine, Tel-Aviv University;Zvulun Medical Center, Clalit Medical Services;Azrieli Faculty of Medicine, Bar Ilan University

关键词: Acromegaly;    Adenoma;    Insulin-like growth factor-1 (IGF-1);    Subclinical;   

DOI  :  10.1507/endocrj.EJ22-0066

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

Patients with acromegaly usually present with the classical signs of acromegaly, whereas patients without the specific signs or symptoms are rarely diagnosed. This unique entity can be named “subclinical acromegaly”. This was a retrospective study. Our study group consisted of 6 patients (4 females) with incidentally diagnosed acromegaly, most following head MRI for unrelated reasons and without the specific signs of acromegaly. Mean age at diagnosis was 48.8 ± 19.2 years. Baseline IGF-1 ranged between 1.3–2.0 × upper limit of normal (ULN). MRI depicted a pituitary microadenoma in 5 patients, and one patient presented with a 12 mm intra-sellar macroadenoma. Mean calculated SAGIT clinical score was 4.8. Three patients underwent trans-sphenoidal resection; two achieved hormonal remission and one improved but did not normalize IGF-1 following surgery. Four patients (including one following surgery) were given somatostatin analogs, and three normalized IGF-1. Several patients improved clinically following treatment, reporting improvement in snoring, hypertension, or weight loss, and pituitary adenoma decreased in size in 2 patients that responded to medical treatment. We report a series of 6 patients with very mild and subclinical acromegaly. It is uncertain whether all such patients will gain clinical benefit from treatment, but most experienced clinical improvement due to treatment.

【 授权许可】

Unknown