Endocrine Abstracts

Introduction

The practice of screening for many chronic diseases, particularly endocrine pathology, is taking place all over the world. The relevance of screening increases significantly when we are talking about diseases with a torpid manifestation and absence of certain clinical symptoms in the debut. Such diseases include pathological conditions caused by pituitary hormone hypersecretion, in particular, acromegaly.

The aim

Of the study was to determine the informative value and specificity of the questions included in the acromegaly primary screening questionnaire on the basis of a comparative analysis.

Material and methods

A questionnaire for screening for acromegaly was developed, which in the final version included 11 questions representing the clinical and phenotypic signs of long-term hypersomatotropinemia. The evaluation was performed on a scale of points, with a maximum of 11 points. The survey was carried out in individuals from the ’risk group’ who came to an outpatient visit to a general practitioner, therapist, cardiologist, endocrinologist for other reasons and in the presence of somatic and/or endocrine pathology (n=1660).

Statistical analysis

Variation statistics using the ’SPSS 19.0 statistical software’ (IBM Corp., Armonk, NY, US).

Results

The maximum sum of points (11) in the questionnaire was found in 2 women in the older age group (over 65), which was 0.12% of the total number of respondents; 8 points in 4 women (0.24%); 7 points in 10 people (4 m/6 f) (0.61%); 6 points in 18 people (4 m/14 f) (1.10%); 5 points in 30 people (4 m/26 f) (1.84%). After in-depth clinical examination, 32 patients were examined to further verify the diagnosis. The examination revealed glucose intolerance in 9 patients (18.8%), diabetes mellitus type 2 in 5 patients (10.4%), hyperprolactinemia in 3 (6.3%) women aged 24 – 37 years, increased IGF-1 level in 2 patients (4.2%). Further examination revealed the presence of pituitary microadenoma in 2 women with high level of blood prolactin. Two patients (1 m/1 f) aged 28 and 57 yrs old respectively with high IGF-1 levels were diagnosed ’acromegaly, tumor stage, active form’.

Conclusion

Screening in high-risk groups revealed hormonally active pituitary tumors (isolated prolactinoma (n = 2) and somatotropinoma (n = 2)) with a frequency of 0.15% per 1000. Such a rather high percentage of detected orphan pathology indicates the effectiveness of the proposed screening technique and the feasibility of its implementation in high-risk groups.

Keywords: acromegaly, primary screening.