Introduction: Arthropathy affects the majority of acromegalic patients and is a major cause of morbidity, absenteeism and impaired quality of life. GH excess and increased levels of circulating IGFI result initially in a marked thickening of the soft tissues and cartilage. Along with disease progression, theres subperiostal bone neoapposition, cartilage regressive phenomena and bone structural changes. We aimed to investigate prevalence, clinical presentation, treatment and impact on quality of life of arthropathy in acromegalic patients.
Description of methods: Demographic and clinical data collection and cross-sectional descriptive study (convenience sample, by telephone) regarding onset, duration and severity of articular symptoms (according to the visual analog scale) and AcroQol-physical dimension.
Results: Off 168 patients, 17 (10.1%) died, 64 (38.1%) had outdated contacts, 39 (23.2%) didnt want to participate/didnt answer the call but 48 (28.6%) did. Off these, 33 (68.8%) were women, mean weight 82.1±14.6 kg (BMI 30.4±4.0 kg/m2), average disease duration of 11.3±9.0 years; 46 (89.6%) were submitted to surgery: 22 (48.9%) are cured, two waiting for results and 19 on medical treatment. Eight (16.7%) performed orthopedic surgery in a mean time of 11.1±8.53 years: one hip replacement, one arthrodesis of foot, one cervical laminectomy, one knee cartilage excision, five knee arthroplasties, one shoulder arthroplasty. Regarding clinical presentation: 17 (35.4%) were asymptomatic, 10 (20.8%) presented knee pain, ten arthralgias, 5 (10.4%) shoulder + knee pain, other being more rare. Average pain intensity was 5±2.5 with joint complaining starting 6.0±6.8 years after diagnosis. In what concerns to AcroQol-phsyical domain, 27.1% referred decreased performance at work or usual tasks and 64.6% arthralgias.
Conclusion: The majority of acromegalic patients had moderate/severe joint complaints and impaired work performance and almost a fifth was submitted to orthopedic surgery. Arthropathy and quality of life should be carefully evaluated in acromegalic patients, despite successful long-term treatment.
03 - 07 May 2014
European Society of Endocrinology