ECEESPE2025 Rapid Communications Rapid Communications 14: Growth Axis and Syndromes (6 abstracts)
Pituitary gigantism: what differences beyond height can we expect compared to acromegaly? a comparison of clinical features and mortality in 3244 patients
Sonia Kaniuka-Jakubowska 1,2 , Mariusz Kaszubowski 3 , Jessica Davis 4 , Dayakshi Abeyaratne 5 , Scott Akker 6 , Natasha Archer 4 , John Ayuk 7 , William Drake 6,8 , Ashley B. Grossman 8 , Mark Gurnell 9 , Claire Higham 10 , Steven Hunter 11 , Donato Iacovazzo 8 , Niki Karavitaki 12 , Tara Kearney 13 , Paul Loughrey 11,14 , Yaasir Mamoojee 15 , Robert D Murray 16 , Aparna Pal 2 , Zoe Plummer 4 , Prakash Abraham 17 , John Wass 2 & Marta Korbonits 8
1Medical University of Gdansk, Department of Endocrinology and Internal Diseases , Gdańsk, Poland; 2Oxford University Hospitals NHS Foundation Trust, Department of Endocrinology at the Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, United Kingdom; 3Gdansk University of Technology, Department of Economic Sciences, Faculty of Management and Economics, Gdansk, Poland; 4Society for Endocrinology, Bristol, United Kingdom; 5University of Ruhuna, Department of Physiology, Faculty of Medicine, Galle, Sri Lanka; 6Bartholomew’s Hospital, Barts Health NHS Trust, London, United Kingdom; 7Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust, Department of Endocrinology, Birmingham, United Kingdom; 8Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Centre for Endocrinology, London, United Kingdom; 9Institute of Metabolic Science, University of Cambridge and NIHR Cambridge Biomedical Research Centre, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom; 10The Christie Hospital NHS Foundation Trust, Department of Endocrinology, Manchester, United Kingdom; 11Royal Victoria Hospital, Regional Centre for Endocrinology and Diabetes, Belfast, United Kingdom; 12University of Birmingham, Centre for Endocrinology, Diabetes and Metabolism, Department of Metabolism and Systems Science, College of Medicine and Health, Birmingham, United Kingdom; 13Salford Royal Foundation Trust, Department of Endocrinology, Salford, United Kingdom; 14Queen’s University Belfast, Patrick G Johnston Centre for Cancer Research, Belfast, United Kingdom; 15Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Department of Endocrinology and Metabolism, Newcastle-upon-Tyne, United Kingdom; 16St James’s, University Hospital, Department of Endocrinology, Leeds Centre for Diabetes & Endocrinology, Leeds, United Kingdom; 17Aberdeen Royal Infirmary, JJR Macleod Centre for Diabetes & Endocrinology, Aberdeen, United Kingdom
JOINT2858
Introduction: Pituitary gigantism and acromegaly, both resulting from excessive growth hormone (GH) production, share the same pathophysiology. The main differences are the age of onset and the patient’s height at diagnosis. However, due to the rarity of pituitary gigantism, it remains unclear whether their clinical course and comorbidities are the same. This study aimed to assess how early-onset GH oversecretion in pituitary gigantism affects disease progression, treatment strategies, and life expectancy.
Methods: From the UK Acromegaly Register (UKAR) and the International Familial Isolated Pituitary Adenoma Consortium, we extracted patients (n=290) meeting criteria for the pituitary gigantism (pituitary gigantism group, PGG). The remaining group from UKAR patients provided the acromegaly group (AG, n=2,954).
Results: Pituitary gigantism comprised 7.8% of GH-excess patients. The equal sex distribution observed in AG does not apply to PGG, where a male predominance is evident (61%). When analysing the onset of disease in AG, we found that the age of diagnosis in women was approximately 5 years later than in men. A similar trend was observed in PGG, where first symptoms (22.6 vs. 27.7 years) and diagnosis (26.9 vs. 31.0 years) occurred earlier in males than in females, with a greater final height in males (3.1 vs. 2.6 SD). AG patients had a similar height to the general population, with a trend for greater height before the age 50 years and lower height afterwards. In PGG patients, a more aggressive clinical disease course is seen: more invasive adenomas – significantly more macroadenomas (75.9% vs. 69.2%) and extrasellar extension (46.8% vs 33.9%), more aggressive surgical approach – more interventions (88.9% vs 83.7%), repeat surgery (23.3% vs 8.4%), and transcranial surgery (12.6% vs 5.0%), and more axis deficiencies per patient at post-treatment assessment (1.5 vs 1.0). The time from diagnosis to disease control was longer in the PGG group. PGG patients have a shorter life expectancy and higher mortality compared to patients with acromegaly (65.0 vs. 73.6 years, adjusted hazard ratio 2.09, 95% CI 1.46-3.04). Their mortality is twice as high compared to the general population (standardised mortality ratio 1.94).SummaryPGG presents a more aggressive disease course, requiring more treatment modalities, with a greater risk of hypopituitarism and higher mortality compared to patients with acromegaly. Therefore, early diagnosis and a concentrated multi-disciplinary effort are essential to reduce long-term morbidity and mortality in patients with pituitary gigantism.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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