Endocrine Abstracts

Acromegaly is a rare disease associated with hypersecretion of growth hormone due to adenoma of somatotroph cells in the pituitary gland, with elevated morbidity and mortality. Acromegaly and thyroid diseases show high co-occurrence. In our study; we aimed to determine the relationship between disease activity at the time of admission and after treatment with the presence of goiter, presence of nodules, and possible accompanying thyroid malignancy in 119 patients with acromegaly that we followed in our clinic. Material Method: Patients age, gender, body mass index, age at diagnosis, pituitary adenoma size, thyroid gland volume, thyroid nodule dimensions, GH (Growth hormone), IGF-1 (Insulin-like growth factor-1) values, thyroid function tests, fasting glucose, insulin, HbA1c, thyroid autoantibody levels, frequency of thyroid malignancy, whether or not pituitary insufficiency developed after pituitary surgery and medical treatments were recorded.

Results: 58% (n=69) of the patients had at least one thyroid nodule. MNG (Multinodular goiter) was present in 47.9% (n=57) of the patients. Patients dominant nodule mean size with thyroid ultrasonography was 13.6±9.8 mm. In the follow-up of the patients, thyroid malignancy was detected in 4.2% (n=5) of the patients. Histopathology was compatible with papillary thyroid carcinoma in all of these patients. A statistically significant correlation was observed between last admission IGF-1 levels and insulin resistance (P=0.019). In addition, a positive correlation was found between HbA1c levels and thyroid nodule size in our study (P=0.025). It was observed that 26.1% of the operated patients developed hypopituitarism. Postoperatively, 59.1% of the patients were treated with a long-acting somatostatin analog, 27.3% with cabergoline, and only 1 patient with pegvisomant.

Conclusion: Nodular thyroid disease is a common condition in patients with acromegaly. For this reason, clinicians should pay attention to the thyroid examination in the physical examination of patients with acromegaly.