Acromegaly in sleep apnoea patients: a large observational study of 755 patients

Acromegaly is a rare, chronic and progressive disease characterised by excess secretion of growth hormone with raised insulin-like growth factor I (IGF-I) levels and usually caused by a pituitary adenoma [1, 2]. Its prevalence is estimated at 40–480 cases per million, depending on the study [1, 3]. The diagnosis of acromegaly, frequently made late because of the insidious nature of the disease, is generally based on symptoms of excess growth hormone, such as acral enlargement, soft-tissue swelling, arthralgia, jaw prognathism, hyperhidrosis, osteoarthritis and frontal bossing, or symptoms of a pituitary adenoma, such as headaches, visual defects or pituitary insufficiency. Owing to prolonged untreated progression of the condition, patients often exhibit established systemic complications at diagnosis, such as diabetes mellitus (19–56%) [2], hypertension (30–40%) and respiratory/cardiac failure (60%) [4, 5], which are the main determinants of prognosis and premature mortality [1]. The majority of new diagnoses of acromegaly are detected by primary care physicians, or specialists other than endocrinologists. The therapeutic options for acromegaly include endoscopic surgery, medical therapies (long-acting somatostatin analogues; dopamine agonists; growth hormone receptor antagonists) and pituitary radiotherapy [6, 7]. 45–80% of acromegaly patients have sleep apnoea syndrome (SAS) [4, 5], compared to 5% in the general population. Because of swelling of the...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep medicine Original Articles: Research letters Source Type: research