Akromegalia — nowe spojrzenie na pacjenta. Polskie propozycje postępowania diagnostyczno-terapeutycznego w akromegalii w świetle aktualnych doniesień

Bolanowski, Marek; Ruchała, Marek; Zgliczyński, Wojciech; Kos–Kudła, Beata; Bałdys-Waligórska, Agata; Zieliński, Grzegorz; Bednarczuk, Tomasz; Hubalewska‐Dydejczyk, Alicja; Kamiński, Grzegorz; Marek, Bogdan; Daroszewski, Jacek; Waśko, Ryszard; Lewiński, Andrzej

doi:10.5603/ep.2014.0045

Cited by 28 publications

(34 citation statements)

References 27 publications

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“…Surgery is the first-line treatment of acromegaly and often is followed by pharmacological therapy and radiotherapy [3]. Transsphenoidal resection of a pituitary tumour either removes or substantially decreases the size of the tumour, thus preventing intracranial complications [1].…”

Section: Introductionmentioning

confidence: 99%

Satysfakcja i preferencje pacjentów dotyczące leczenia lanreotydem Autogel w akromegalii

Witek

Mucha²,

Ruchała

2016

Endokrynologia Polska

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Introduction: Despite the known importance of somatostatin analogues (SSAs) in the treatment of acromegaly, patient satisfaction leading to preferences for specific SSAs have received little attention so far. Material and methods:This open, prospective, observational, multicentre patient-reported outcome study included adult patients with acromegaly, who switched from another SSA to lanreotide Autogel (new and previous devices) at least two months prior to enrolment. The observation period was around 12 months. The primary outcome assessed was overall treatment satisfaction, measured using the five-point Likert scale. The secondary outcomes were: 1) treatment effectiveness, in terms of symptom control; 2) technical problems related to treatment administration, measured by the Visual Analog Scale (VAS); and 3) ease and safety of lanreotide Autogel delivery (new device vs. previous device). Results: Of the 102 patients who completed the study, 97 (95.1%) were "completely or rather satisfied" with lanreotide Autogel therapy, four (3.9%) were "neither satisfied nor dissatisfied", and one (1%) was "rather dissatisfied". Symptom control was reported as "excellent" or "good" by 88-89% of patients throughout the study. Patients reported fewer technical problems related to administration of lanreotide Autogel (final mean VAS: 5.3) compared to previous SSAs (mean VAS: 37.6). Of the 31 patients treated with lanreotide Autogel using the previous device followed by the new device, 64.5% reported the new device as improved. Conclusions: Lanreotide Autogel therapy resulted in greater patient satisfaction with overall acromegaly management, when compared to previous SSAs. The new lanreotide Autogel device was found to be easier to use than the previous one. (Endokrynol Pol 2016; 67 (6): 572-579)

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Section: Introductionmentioning

confidence: 99%

Satysfakcja i preferencje pacjentów dotyczące leczenia lanreotydem Autogel w akromegalii

Witek

Mucha²,

Ruchała

2016

Endokrynologia Polska

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“…therefore, the most serious complications of acromegaly, especially with concomitant diabetes, are cancers, mainly of the gastrointestinal tract, but also of other organs: breast, prostate, brain [2,9,10,13,16]. in the group of 106 patients suffering from acromegaly with concomitant diabetes, wen-ko et al demonstrated a higher prevalence of cancers as compared to patients with acromegaly without diabetes (13.2% vs. 3.5%; p < 0.01) [12].…”

Section: Discussionmentioning

confidence: 99%

“…the consequence of the disease is the excessive production of growth factors (mainly insulin-like growth factor-1, igF-1), which leads to characteristic changes in the appearance of patients, organ and metabolic complications and neoplasms [1,2]. slow changes in appearance and the rich symptomatology of acromegaly are a frequent cause of diagnostic errors in the practice of general Practitioners and delay diagnosis of the disease by an average of 5-10 years.…”

Section: Introductionmentioning

confidence: 99%

“…one of the most common complications of acromegaly is disturbed carbohydrate metabolism, and this affects more than half of patients with various degrees of disease severity: hyperinsulinaemia (up to 80%), glucose intolerance (up to 40%), and diabetes (up to 20%) [2]. Diabetes (diabetes mellitus -DM) in the course of acromegaly belongs to a heterogeneous group of secondary diabetes (of known etiology and pathogenesis).…”

Section: Introductionmentioning

confidence: 99%

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Disorders of carbohydrate metabolism and their relationship with the prevalence of cancer in patients with acromegaly – authors’ own observations

Malicka¹,

Kurowska²,

Dudzińska³

et al. 2016

fmpcr

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A -study Design, B -Data collection, C -statistical analysis, D -Data interpretation, E -Manuscript Preparation, F -literature search, G -Funds collection Background. acromegaly is a rare chronic disease with an excessive secretion of growth hormone, which leads to characteristic changes in appearance, organ and metabolic complications and neoplasms, which are a significant cause of shortened survival time. one of the most common consequences of acromegaly is disturbed carbohydrate metabolism. Objectives. the aim of this study was to assess the prevalence of disorders of carbohydrate tolerance and their relationship with the prevalence of malignant tumours in subjects with acromegaly. Material and methods. the study group comprised 69 patients with confirmed acromegaly (26 M, 43 F), aged 26-83 (mean 58.9 ± 11.0). Medical histories and the results of laboratory tests -plasma fasting glucose and oral glucose tolerance test, as well as the results of imaging and histopathological examinations performed in cases of suspected cancer lesions were analyzed. Results. Disorders of carbohydrate tolerance were confirmed in a total of 46 patients (66.7%). 23 patients (33.3%) had normal glucose tolerance. Diabetes was diagnosed in 22 patients (31.9%), while prediabetes was diagnosed in 24 (34.8%) patients. in the analyzed group there were 6 cases of cancers, including 5 patients with concomitant diabetes, which represented a value significantly higher (p = 0.01) compared to patients without diabetes. the sixth case of cancer was detected in a woman with igt. in patients with normal glucose tolerance there was no case of cancer. Conclusions. among patients with acromegaly, disorders of carbohydrate tolerance occur in more than half of the cases, which confirms the need for active screening in this group of patients, in which a significant role is played by general Practitioners. general Practitioners should also consider the possibility of acromegaly in the differential diagnosis of glucose tolerance disorders detected in their patients. all patients with acromegaly, especially with concomitant diabetes or prediabetes, should be screened for cancers. Key words: acromegaly, diabetes, prediabetes, malignancy.

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“…Hypersecretion of GH and IGF1 effect the whole body and lead to multisystemic complications, including those involving the gastrointestinal system [2,3]. In terms of organic gastrointestinal disorders, adenomatous polyps and colon carcinoma are the most significant complications associated with acromegaly [4].…”

Section: Introductionmentioning

confidence: 99%

Akromegalia może wiązać się z zaburzeniami rozkurczu dolnego zwieracza przełyku (LES)

İlhan

Danalıoğlu

Turgut

et al. 2015

Endokrynologia Polska

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Introduction: Although prolonged small intestine and colonic transit time has been demonstrated in acromegaly patients, the influence of acromegaly on oesophagus motility and the pathological mechanisms involved are still not clarified. We aimed to investigate manometric measurements to ascertain whether oesophagus motility is affected in active acromegaly patients. Material and methods:The study was performed in an institutional referral centre at a tertiary care hospital. Twenty-three acromegaly patients (mean age 43.2 ± 13.2 years) and 25 sex-and age-matched healthy control subjects (mean age 48.6 ± 7.9 years) were recruited to a case-control study. Oesophageal manometry was performed using MMS (Medical Measurement Systems, Netherlands) Solar GI -Air Charged Intelligent Gastrointestinal Conventional Manometry. Results: In manometric measurements the lower oesophageal sphincter pressure was 18 ± 7 mmHg in acromegaly patients and 15.6 ± 4.4 mm Hg in controls, and there was no significant difference (p = 0.17). The percentage of relaxation was 64.8% and 81.8%, respectively, and it was significantly lower in acromegaly patients than in controls (p < 0.001). Additionally, the duration of relaxation was found to be 4 ± 1.9 seconds and 5 ± 1.7 seconds in patients and controls, respectively (p = 0.049). Conclusions:Our study has demonstrated a significant reduction in the percentage and duration of lower oesophageal sphincter relaxation in oesophagus motility even in acromegaly patients without any gastrointestinal symptoms. Further clinical and pathophysiological studies are required to clarify the underlying mechanisms of gastrointestinal motility disorders in acromegaly. (Endokrynol Pol 2015; 66 (4): 308-312)

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Akromegalia — nowe spojrzenie na pacjenta. Polskie propozycje postępowania diagnostyczno-terapeutycznego w akromegalii w świetle aktualnych doniesień

Cited by 28 publications

References 27 publications

Satysfakcja i preferencje pacjentów dotyczące leczenia lanreotydem Autogel w akromegalii

Satysfakcja i preferencje pacjentów dotyczące leczenia lanreotydem Autogel w akromegalii

Disorders of carbohydrate metabolism and their relationship with the prevalence of cancer in patients with acromegaly – authors’ own observations

Akromegalia może wiązać się z zaburzeniami rozkurczu dolnego zwieracza przełyku (LES)

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