Rosario Pedro Weslley, Calsolari Maria Regina
Santa Casa de Belo Horizonte, Brazil.
Neuroendocrinology Department, Santa Casa de Belo Horizonte, Brazil.
Arq Bras Endocrinol Metabol. 2014 Nov;58(8):807-11. doi: 10.1590/0004-2730000003314. Epub 2014 Nov 1.
To determine the value of acromegaly screening in adult patients not reporting enlargement of the extremities, but who present arterial hypertension associated with at least one other comorbidity of the disease.
Patients seen by general practitioners at primary health care units were evaluated. Among the patients without extremity enlargement, those with recently diagnosed arterial hypertension associated with at least one other comorbidity were selected.
A total of 1,209 patients were submitted to laboratory investigation. Elevated IGF-1 was observed in 22 patients. Eighteen patients had adequate suppression of growth hormone (GH). No GH suppression was observed in four women with confirmed elevated IGF-1. In the latter, IGF-1 and nadir GH were only slightly elevated, magnetic resonance showed a normal pituitary, and chest and abdominal computed tomography revealed no tumor, and no intervention was performed.
In patients with arterial hypertension without known pituitary disease, acromegaly is unlikely in the absence of enlargement of the extremities.
确定在未报告肢体增大但患有与该疾病至少一种其他合并症相关的动脉高血压的成年患者中进行肢端肥大症筛查的价值。
对在初级卫生保健单位就诊的全科医生所诊治的患者进行评估。在无肢体增大的患者中，选取近期诊断为动脉高血压且伴有至少一种其他合并症的患者。
共有1209例患者接受了实验室检查。22例患者观察到胰岛素样生长因子-1（IGF-1）升高。18例患者生长激素（GH）得到充分抑制。4例IGF-1升高得到证实的女性未观察到GH抑制。在后者中，IGF-1和最低值GH仅略有升高，磁共振成像显示垂体正常，胸部和腹部计算机断层扫描未发现肿瘤，未进行干预。
在无已知垂体疾病的动脉高血压患者中，若没有肢体增大，肢端肥大症的可能性不大。
