Introduction: Acromegaly is a rare endocrine disorder of the growth hormone (GH)-insulin-like growth factor 1 (IGF1) metabolism that can affect women of fertile age. Although uncommon, pregnancies in acromegalic women can occur, with data regarding the management of these cases being very limited, mostly consisting of case reports.Case Presentation: We present the case of an acromegalic woman, first diagnosed at the age of 22, after the surgical resection of a pituitary mass. Throughout the evolution, she received conventional radiotherapy and has been treated with somatostatin receptor ligands (SRLs), dopamine agonists (DAs), and GH-blockers. At the age of 37, the patient decided to become pregnant while she was on Pegvisomant and DA therapy. The treatment was stopped, and the patient became pregnant at the age of 38. Tumor size and IGF-1 values have remained stable throughout the pregnancy, and no complications occurred. A healthy child with normal birth weight was delivered on term through Cesarean section.Conclusions: Managing pregnant women with acromegaly is challenging because of the little available data regarding the safety of medical treatment and a high interindividual variability of GH-IGF-1 evolution during this period. The particularity of our case was a patient with a long history of acromegaly, who had an uneventful pregnancy despite stopping all medical treatment.
Objective: The purpose of this study was to investigate the benefits of two different Selenium based supplements on patients with chronic autoimmune thyroiditis.Methods: We conducted a prospective study on 50 patients with chronic autoimmune thyroiditis, who were divided into three different treatment groups, one group taking Selenium 100 μg, one Procor T (a combination of Selenium 100 μg and other elements like copper, Zinc and Q10 Conenzyme) and one control group taking Placebo pills. We measured on two follow up visits the antibody levels (anti-thyroidperoxidase- TPO Ab) and offered each patient a standardised questionnaire regarding the thyroid-related quality of life (THYPROro).Results: At the 6 months follow up visit there was a statistically significant decrease in the antibody levels for each treatment group compared to the base levels. The THYPROro questionnaire scores showed an improvement in most aspects regarding the quality of life as well, but there was no significant difference between the placebo and the treated groups in the magnitude of this improvement.Conclusions: Based on our results, we could not identify a certain benefit in improving quality of life with the supplementation of Selenium, as the improvements were at a similar level for the patients who took Placebo pills. Further studies with more patients, as well as taking the Selenium defficiency in consideration (by measuring the basal serum level of Selenium for each patient) would be required to find the target group of patients who could have most benefits of Selenium-based supplementation.
Introduction
Acromegaly is a rare chronic endocrine disorder that can lead to significant quality of life (QoL) impairment and persistent symptomatology in both biochemically uncontrolled as well as in cured or controlled patients. We aimed to conduct an observational cross-sectional study investigating the associations between biochemical disease control, associated comorbidities, and symptoms severity on QoL in a cohort of acromegalic patients.
Methods
Thirty-one patients with acromegaly were enrolled in our study. AcroQoL and PASQ (Pain assessed acromegaly symptoms questionnaire) questionnaires were applied to all patients. Information about disease status, associated comorbidities, and other relevant clinical and paraclinical data were gathered.
Results
Patients with uncontrolled acromegaly presented worse QoL and symptoms scores than controlled patients, but the difference was not statistically significant (AcroQoL 57.22 vs 64.04, p > 0.05; PASQ 12 vs 16.47, p > 0.05). Worse symptoms were significantly associated with impaired QoL (overall symptoms score on PASQ was negatively correlated with AcroQoL total score, r = − 0.61, p < 0.05). Cardiovascular complications were associated with lower QoL scores, but not with worse symptoms (AcroQoL total score in patients with- versus patients without cardiovascular complications: 54.89 vs 70.14, p < 0.05).
Conclusions
Achieving biochemical control of acromegaly might not be enough to reverse the QoL impairment and improve symptomatology in acromegalic patients. While symptoms severity and the presence of cardiovascular complications seem to play an important role in reducing patients QoL, the roles of disease control, diabetes, and pituitary insufficiency are less clear.
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