Pelsma Iris C M, Kroon Herman M, Andela Cornelie D, van der Linden Enrike M J, Kloppenburg Margreet, Biermasz Nienke R, Claessen Kim M J A
Department of Medicine, Division of Endocrinology, and Center for Endocrine Tumors Leiden, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Pituitary. 2024 Dec;27(6):824-836. doi: 10.1007/s11102-024-01465-1. Epub 2024 Nov 1.
Following the description of an illustrative case of a 70-year-old female patient with longstanding active acromegaly and invalidating, progressive joint complaints, current insights regarding diagnosis, treatment, and long-term management of acromegalic arthropathy are summarized. Since clinical trials on this topic are lacking, the reported recommendations are based on extensive clinical and research experience with this clinical entity, and on established diagnostics and interventions in patients with other rheumatic diseases. The cornerstones of the management of acromegalic arthropathy remains normalization of growth hormone and insulin growth factor-1 levels. However, patients with severe or progressive acromegalic arthropathy require a multidisciplinary approach to determine adequate diagnostics and treatment options. Because of the high prevalence and invalidating character of acromegalic arthropathy, developing evidence-based effective prevention and treatment strategies, preferably by international collaboration within rare disease networks, e.g., Endo-ERN, is a clear unmet need.
在描述了一名患有长期活动性肢端肥大症且有关节疼痛、进行性加重并致残的70岁女性患者的典型病例后，总结了目前关于肢端肥大症性关节病的诊断、治疗及长期管理的见解。由于缺乏关于该主题的临床试验，所报告的建议基于对这一临床实体的广泛临床和研究经验，以及对其他风湿性疾病患者既定的诊断方法和干预措施。肢端肥大症性关节病管理的基石仍然是生长激素和胰岛素样生长因子-1水平的正常化。然而，患有严重或进行性肢端肥大症性关节病的患者需要多学科方法来确定适当的诊断和治疗方案。鉴于肢端肥大症性关节病的高患病率和致残特性，制定基于证据的有效预防和治疗策略，最好通过罕见病网络（如内分泌罕见病欧洲参考网络）内的国际合作来实现，这显然是一个尚未满足的需求。
