Approach to the patient with controlled acromegaly and acromegalic arthropathy: clinical diagnosis and management.

IF 3.3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM Pituitary Pub Date : 2024-11-01 DOI:10.1007/s11102-024-01465-1

Iris C M Pelsma, Herman M Kroon, Cornelie D Andela, Enrike M J van der Linden, Margreet Kloppenburg, Nienke R Biermasz, Kim M J A Claessen

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Abstract

Following the description of an illustrative case of a 70-year-old female patient with longstanding active acromegaly and invalidating, progressive joint complaints, current insights regarding diagnosis, treatment, and long-term management of acromegalic arthropathy are summarized. Since clinical trials on this topic are lacking, the reported recommendations are based on extensive clinical and research experience with this clinical entity, and on established diagnostics and interventions in patients with other rheumatic diseases. The cornerstones of the management of acromegalic arthropathy remains normalization of growth hormone and insulin growth factor-1 levels. However, patients with severe or progressive acromegalic arthropathy require a multidisciplinary approach to determine adequate diagnostics and treatment options. Because of the high prevalence and invalidating character of acromegalic arthropathy, developing evidence-based effective prevention and treatment strategies, preferably by international collaboration within rare disease networks, e.g., Endo-ERN, is a clear unmet need.

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控制性肢端肥大症和肢端肥大性关节病患者的治疗方法：临床诊断和管理。

本报告描述了一例 70 岁女性患者的病例，该患者患有长期活动性肢端肥大症，并伴有无效的进行性关节不适，报告总结了目前有关肢端肥大症关节病的诊断、治疗和长期管理的见解。由于缺乏相关的临床试验，报告中的建议是基于对这一临床实体的广泛临床和研究经验，以及对其他风湿性疾病患者的既定诊断和干预措施。治疗渐冻人关节病的基石仍然是使生长激素和胰岛素生长因子-1 水平恢复正常。然而，严重或进行性肢端肥大症关节病患者需要采用多学科方法来确定适当的诊断和治疗方案。由于肢端肥大性关节病的高发病率和无效性特点，制定以证据为基础的有效预防和治疗策略，最好是通过罕见病网络（如 Endo-ERN）内的国际合作来实现，这显然是一个尚未满足的需求。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pituitary 医学-内分泌学与代谢

CiteScore

7.10

自引率

7.90%

发文量

审稿时长

6 months

期刊介绍： Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease. The journal considers: Biology of Pituitary Tumors Mechanisms of Pituitary Hormone Secretion Regulation of Pituitary Function Prospective Clinical Studies of Pituitary Disease Critical Basic and Clinical Reviews Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.

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