Clinical presentation and management of acromegaly in elderly patients
| العنوان: | Clinical presentation and management of acromegaly in elderly patients |
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| المؤلفون: | Daniela Regazzo, Filippo Ceccato, Mattia Barbot, Laura Lizzul, Andrea Daniele, Isabella Merante Boschin, Alois Saller, Elisa Selmin, Angela Cuccarollo, Carla Scaroni, Gianluca Occhi |
| المصدر: | Hormones (Athens, Greece) |
| بيانات النشر: | Springer International Publishing, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Adenoma, medicine.medical_specialty, Pediatrics, Aging, Bone disease, Endocrinology, Diabetes and Metabolism, 030209 endocrinology & metabolism, 03 medical and health sciences, 0302 clinical medicine, Acromegaly, Diagnosis, medicine, Humans, Pituitary Neoplasms, Aged, Retrospective Studies, Medical treatment, business.industry, Incidence (epidemiology), Retrospective cohort study, General Medicine, medicine.disease, Colon polyps, Cross-Sectional Studies, Cohort, Original Article, Neurosurgery, business, 030217 neurology & neurosurgery, Rare disease |
| الوصف: | Background and aim Acromegaly is a rare disease with a peak of incidence in early adulthood. However, enhanced awareness of this disease, combined with wide availability of magnetic resonance imaging (MRI), has increased the diagnosis of forms with mild presentation, especially in elderly patients. Moreover, due to increased life expectancy and proactive individualized treatment, patients with early-onset acromegaly are today aging. The aim of our study was to describe our cohort of elderly patients with acromegaly. Materials and methods This is a cross-sectional retrospective study of 96 outpatients. Clinical, endocrine, treatment, and follow-up data were collected using the electronic database of the University Hospital of Padova, Italy. Results We diagnosed acromegaly in 13 patients, aged ≥65 years, presenting with relatively small adenomas and low IGF-1 secretion. Among them, 11 patients were initially treated with medical therapy and half normalized hormonal levels after 6 months without undergoing neurosurgery (TNS). Remission was achieved after TNS in three out of four patients (primary TNS in two); ten patients presented controlled acromegaly at the last visit. Acromegaly-related comorbidities (colon polyps, thyroid cancer, adrenal incidentaloma, hypertension, and bone disease) were more prevalent in patients who had an early diagnosis (31 patients, characterized by a longer follow-up of 24 years) than in those diagnosed aged ≥65 years (5 years of follow-up). Conclusions Elderly acromegalic patients are not uncommon. Primary medical therapy is a reasonable option and is effectively used, while the rate of surgical success is not reduced. A careful cost-benefit balance is suggested. Disease-specific comorbidities are more prevalent in acromegalic patients with a longer follow-up rather than in those diagnosed aged ≥65 years. |
| اللغة: | English |
| تدمد: | 2520-8721 1109-3099 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::268def2bbaa4f9f41fdf12f940462a40Test http://europepmc.org/articles/PMC7889670Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....268def2bbaa4f9f41fdf12f940462a40 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 25208721 11093099 |
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