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Endocrine. 2019 Jan;63(1):120-129. doi: 10.1007/s12020-018-1764-4. Epub 2018 Sep 29.

Signs and symptoms of acromegaly at diagnosis: the physician's and the patient's perspectives in the ACRO-POLIS study.

Author information

1
Hôpital Larrey, Toulouse, France.
2
Aix-Marseille University, INSERM, MMG, AP-HM, Hôpital de la Conception, CRMR HYPO, Marseille, France.
3
Groupement Hospitalier Est, Lyon, France.
4
Hôpital Haut Lévêque-CHU de Bordeaux, Bordeaux, France.
5
Rouen University Hospital, Endocrinology Unit, Inserm CIC-CRB 1404, F 76 000, Rouen, France.
6
CHU de Reims, Reims, France.
7
CHU Bretonneau, Tours, France.
8
Ipsen Pharma, Boulogne-Billancourt, France.
9
Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Centre de Référence des Maladies Rares de l'Hypophyse HYPO, F94275, Le Kremlin-Bicêtre, France. caron.p@chu-toulouse.fr.
10
Université Paris-Sud, Le Kremlin-Bicêtre, France. caron.p@chu-toulouse.fr.

Abstract

PURPOSE:

Acromegaly is characterized by a broad range of manifestations. Early diagnosis is key to treatment success, but is often delayed as symptomatology overlaps with common disorders. We investigated sign-and-symptom associations, demographics, and clinical characteristics at acromegaly diagnosis.

METHODS:

Observational, cross-sectional, multicenter non-interventional study conducted at 25 hospital departments in France that treat acromegaly (ClinicalTrials.gov: NCT02012127). Adults diagnosed with acromegaly < 5 years were enrolled. Demographic and clinical data were obtained from medical reports and patient questionnaires. Sign-and-symptom associations were assessed by multiple correspondence analysis (MCA).

RESULTS:

Overall, 472 patients were included in the analyses. MCA was unsuccessful in identifying sign-and-symptom associations at diagnosis. Endocrinologists (29.5% patients) and other clinical specialists (37.2% patients) were commonly first to suspect acromegaly. Morphologic manifestations (83.7-87.9% patients), snoring syndrome (81.4% patients), and asthenia (79.2% patients) were frequently present at diagnosis; differences were found between sexes for specific manifestations. Rates of discrepancy between patient- and physician-reported manifestations were highest for functional signs. Earliest manifestations prior to diagnosis, according to how they were detected, were enlarged hands and feet (6.4 ± 6.8 and 6.2 ± 6.9 years, functional signs), hypertension (6.6 ± 7.5 years, complementary examination) and carpal/cubital tunnel syndrome (5.7 ± 6.7 years, functional signs with complementary examination).

CONCLUSIONS:

Results confirm the broad range of manifestations at diagnosis and delay in recognizing the disease. We identified early manifestations and sex differences that may aid physicians in diagnosing acromegaly. Discrepancy rates suggest physicians should obtain the patient's perspective and seek functional signs during diagnosis.

KEYWORDS:

Acromegaly; Diagnosis; Multiple correspondence analysis; Sign-and-symptom association

PMID:
30269264
PMCID:
PMC6329724
DOI:
10.1007/s12020-018-1764-4
[Indexed for MEDLINE]
Free PMC Article

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