Adrenal morpho-functional alterations in patients with acromegaly.
Acromegaly is associated with a greater morbidity and higher incidence of tumors, possibly due to the permissive role of elevated GH and IGF-I levels. In the general population, adrenal masses are frequently discovered (prevalence 1-5%) at computed tomography (CT). We evaluated the prevalence of adrenal lesions in patients with acromegaly. We studied 94 acromegalic patients, 54 females (mean age 55.0+/-16.0 yr) and 40 males (mean age 50+/-14 yr) referred to 5 Endocrinology Units between 2001-2003; 49 had active disease and 45 had been treated with surgery and/or were controlled with medical therapy. Abdominal CT showed adrenal lesions in 27 patients; 9 of them had unilateral masses (10%) with benign features (diameter 0.5-3 cm) and 18 had hyperplasia (14 monolateral and 4 bilateral), with no significant differences between patients with active vs controlled disease, and with no correlation between prevalence of masses and duration of disease, GH and IGF-I levels. Hormone study (urinary free cortisol, catecholamines/metanephrines, upright plasma renin activity and aldosterone, morning plasma ACTH and low-dose dexamethasone suppression test) disclosed no major endocrine alterations. During a 1-yr follow-up, the adrenal masses increased in size in 3 cases and 1 patient also developed subclinical Cushing's syndrome. Adrenal lesions seem more frequent in acromegaly than in the general population, but no single factor (GH/IGF-I levels or disease duration) predicts them. The masses appear to be benign and nonhypersecreting, but a longer follow-up is recommended to disclose any changes in their morphofunctional state.
Scaroni
C
C
Department of Medical and Surgical Sciences, Endocrinology Unit, University of Padua, 35128 Padua, Italy. carla.scaroni@unipd.it
Selice
R
R
Benedini
S
S
De Menis
E
E
Arosio
M
M
Ronchi
C
C
Gasperi
M
M
Manetti
L
L
Arnaldi
G
G
Polenta
B
B
Boscaro
M
M
Albiger
N
N
Martino
E
E
Mantero
F
F
D000172:Acromegaly / Q000097:blood / Q000473:pathology* / Q000503:physiopathology*; D000311:Adrenal Glands / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I
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