Endocrine Abstracts (2017) 49 EP940 | DOI: 10.1530/endoabs.49.EP940

Duhok/IRAQ acromegaly; one year of experience

Bayar Qasim

Unviersity of Duhok/College of Medicine, Duhok, Iraq.

Background: Acromegaly is a rare hormonal disorder; the prevalence is ~60 cases/million population1, Incidence: 3.3 new cases/million/year1 Mortality rate 2–4 times that of general population2. It is usually the result of a somatotrope adenoma in more than 95% of cases.

Aim: By June 2016, we were celebrating one year of experience in acromegaly. It was first time to open acromegaly service in Duhok city/Kurdistan region/IRAQ. This review will include all registered patients during this year. Aim of this revision to give a brief about our patients’ characteristics and how we can plan for future?

Methods: This is retrospective study involving ten patients, all patients diagnosed by high IGF1 level followed by GH suppression test and MRI of pituitary gland. Those patients underwent transphenoidal resection, diagnosis confirmed by histopathology too.

Results: Our patients characteristics are shown. The median age of presentation was 44.9. Headache and acral enlargement was the most common presentation.

Discussion: Most patients with acromegaly are diagnosed with a macroadenoma. This review include ten patients, eight of them were from Duhok including Zaxo and Akre, two of them they moved to live in this city, one from the capital Baghdad and another patient from syrian refugee. The prevalence of acromegaly in Duhok city was 8.2 persons/million/year 4, while the incidence was of new cases was 5.3/million/year. This high number of patients reflects the new input for patients to this service as this was not present before June 2015. Eight patients were operable they prepared by somatostatin analogue followed by surgery.

Conclusion and recommendations: The two dilemmas we are facing here in Duhok/IRAQ are: First; delayed diagnosis as reflected by the fact all of our patients are macroadenoma at presentation, that is why we need to increase awareness about this disease. Secondly; low compliance for medical treatment: to improve this we need to provide free measurement of both GH and IGF1 levels for all patients receiving somatostatin analogue treatment.

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