In acromegaly, carpal tunnel syndrome is also related to median nerve oedema

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Publication date: Available online 29 September 2020Source: Journal of OrthopaedicsAuthor(s): Amanda Spielman, Sriram Sankaranarayanan, Piotr Skowronski, Anne-Sophie Lessard, Zubin Panthaki
Source: Journal of Orthopaedics - Category: Orthopaedics Source Type: research
Clinical features of soft tissue amyloid light-chain (AL) amyloidosis include macroglossia, arthropathy, muscle pseudohypertrophy, skin plaques, and carpal tunnel syndrome. Vascular manifestations of AL amyloid include periorbital ecchymosis, jaw or limb claudication, and even myocardial infarction caused by occlusion of small vessel coronary arteries. Some of these features, such as macroglossia, periorbital ecchymosis, and the so-called shoulder-pad sign, are pathognomonic for AL amyloidosis. These findings may be the initial presenting features of the disease, and the recognition of these red flag symptoms is very impor...
Source: Hematology/Oncology Clinics of North America - Category: Cancer & Oncology Authors: Source Type: research
Drivers of sporadic benign pituitary adenoma growth are largely unknown. Whole-exome sequencing of 159 prospectively resected pituitary adenomas showed that somatic copy number alteration (SCNA) rather than mutation is a hallmark of hormone-secreting adenomas and that SCNAs correlate with adenoma phenotype. Using single-gene SCNA pathway analysis, we observed that both cAMP and Fanconi anemia DNA damage repair pathways were affected by SCNAs in growth hormone–secreting (GH-secreting) somatotroph adenomas. As somatotroph differentiation and GH secretion are dependent on cAMP activation and we previously showed DNA dam...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
CONCLUSION: This small, observational registry study showed a relevant success rate of initial pituitary surgery in patients with confirmed acromegaly. Initial tumour size and postoperative IGF-1 levels help to risk stratify patients regarding expected outcomes. In the case of disease persistence, a multimodal approach using drug and radiotherapy is mandatory. PMID: 30141524 [PubMed - in process]
Source: Swiss Medical Weekly - Category: General Medicine Authors: Tags: Swiss Med Wkly Source Type: research
ConclusionOur findings emphasize the high prevalence of peripheral nervous system involvement in acromegaly patients under SSA therapy and importance of neurological evaluation of these patients. Early diagnosis and treatment of the disease may reduce the PNS involvement.
Source: Journal of Endocrinological Investigation - Category: Endocrinology Source Type: research
Horm Metab ResDOI: 10.1055/s-0042-100913Early diagnosis of acromegaly prevents irreversible comorbidities and facilitates surgical cure. Carpal tunnel syndrome (CTS) is common in acromegaly and patients have often undergone surgery for CTS prior to the diagnosis of acromegaly. We hypothesized that screening CTS-patients for acromegaly could facilitate active case-finding. We prospectively enrolled 196 patients [135 women, 56.9 (range 23–103) years] who presented with CTS for surgery. Patients were asked about 6 symptoms suggestive of acromegaly using a questionnaire calculating a symptom score (0–6 points), and...
Source: Hormone and Metabolic Research - Category: Endocrinology Authors: Tags: Endocrine Care Source Type: research
Just when you thought your brain could unwind on a Friday, you realise that it would rather be challenged with some good old fashioned medical trivia…introducing Funtabulously Frivolous Friday Five 120 Question 1 What rheumatological condition does Rembrandt’s Scholar have? + Reveal the Funtabulous Answer expand(document.getElementById('ddet1210722826'));expand(document.getElementById('ddetlink1210722826')) Scleroderma He has a pinched nose, tight mouth, pale face with a malar flush, his hands are puffy and the joints on his right thumbs are swollen. Could this be Scleroderma? [Reference] Question 2 When Ra...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Tags: Frivolous Friday Five collapse dentist FFFF hands Kluver-bucy syndrome melanoma pleural collapse rachmaninoff rachmaninov Rembrandt scleroderma TB teeth temporal lobe Source Type: blogs
ConclusionsOnce validated in independent studies, ACROSCORE may represent a new tool for the clinical screening of acromegaly that can be used by general practitioners and non‐endocrinology specialists.This article is protected by copyright. All rights reserved.
Source: Clinical Endocrinology - Category: Endocrinology Authors: Tags: Original Article Source Type: research
This study evaluated the median nerve in acromegalic patients with and without CTS. Methods We examined the median nerves of 21 acromegalic patients (eight patients with CTS and 13 patients without CTS) using electrophysiological nerve conduction studies and wrist magnetic resonance images. They underwent transsphenoidal surgery to resect their growth hormone-secreting pituitary adenomas. The median nerves of the patients with CTS were reassessed by the same studies. Results The sensory conduction velocity was significantly later in the...
Source: Pituitary - Category: Endocrinology Source Type: research
This study included 313 participants, of whom 181 were women. The mean age was 48.8 ± 12.0 years. Patients most frequently presented with acral growth of hands and feet (32.6 %) and headache (26.2 %). Internists were the medical specialists who were most frequently first consulted (29.4 %) then neurosurgeons (11.8 %). Acromegaly was generally diagnosed by endocrinologists (55 %), followed by neurosurgeons (23 %). The median elapsed period prior to diagnosis was 24 months, interquartile range 6.0–48.0 months. Some 45.7 % had undergone surgery; 35.2&nbs...
Source: Journal of Endocrinological Investigation - Category: Endocrinology Source Type: research
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