Guerboub Ahmed Anass, Issouani Jad, Joumas Kesly Jeny, Er Rahali Yassine
Endocrinology Department, Mohammed V Military Academic Hospital, Faculty of Medicine and Pharmacy, Mohammed V-Souissi University, Rabat, Morocco.
Pan Afr Med J. 2023 Dec 27;46:116. doi: 10.11604/pamj.2023.46.116.41952. eCollection 2023.
Acromegaly is defined as an acquired dysmorphytic syndrome due to excessive secretion of growth hormone (GH) and consequently of insulin-like growth factor-1 (IGF-1). This is a retrospective study of patients who were hospitalized in the Endocrinology Department of the Mohammed V Military Academic Hospital in Rabat over a period of 14 years (2008 to 2022), reporting on their clinical, paraclinical and evolutionary profiles and comparing the results with the data in the literature. Nineteen patients were included in our study. The mean age was 42.7 ± 11.6 years, with a male predominance. The clinical manifestations were dominated by a dysmorphic syndrome present in 97.4% of cases, followed by complications related to acromegaly in 88.9% of cases. The diagnosis was made when GH and IGF-1 values were elevated in 88.9% and 93.8% of cases, respectively; with a mean GH value of 25.1 μg/L. Magnetic resonance imaging (MRI) was used to diagnose the location of pituitary adenoma in all cases, 78.9% of which were macroadenomas and 21.1% microadenomas. The majority of patients (78.9%) had recourse to transsphenoidal surgery. Medical treatment was carried out in 89.5% of cases. Postoperative radiotherapy was performed in 33% of cases. Disease control was achieved in 30.1% of cases. This study shows the complex management of acromegaly. Disease control is a necessary condition in order to avoid complications, but is often difficult to obtain.
肢端肥大症被定义为一种由于生长激素(GH)过度分泌以及随之而来的胰岛素样生长因子-1(IGF-1)过度分泌导致的后天性畸形综合征。这是一项对在拉巴特穆罕默德五世军事学术医院内分泌科住院14年(2008年至2022年)的患者进行的回顾性研究,报告了他们的临床、辅助检查和病情演变情况,并将结果与文献数据进行比较。我们的研究纳入了19名患者。平均年龄为42.7±11.6岁,男性占主导。临床表现以97.4%的病例出现畸形综合征为主,其次是88.9%的病例出现与肢端肥大症相关的并发症。分别在88.9%和93.8%的病例中,当GH和IGF-1值升高时做出诊断;平均GH值为25.1μg/L。所有病例均使用磁共振成像(MRI)诊断垂体腺瘤的位置,其中78.9%为大腺瘤,21.1%为微腺瘤。大多数患者(78.9%)接受了经蝶窦手术。89.5%的病例进行了药物治疗。33%的病例进行了术后放疗。30.1%的病例实现了疾病控制。这项研究表明了肢端肥大症的复杂管理。疾病控制是避免并发症的必要条件,但往往难以实现。