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acromegaly bone

Paula Pb Silva, Fatemeh Ghazanfari Amlashi, Elaine W Yu, Karen J Pulaski-Liebert, Anu Gerweck, Pouneh Fazeli, Elizabeth A Lawson, Lisa B Nachtigall, Beverly M K Biller, Karen K Miller, Anne Klibanski, M Bouxsein, Nicholas A Tritos
CONTEXT: Both acromegaly and adult growth hormone deficiency (GHD) are associated with increased fracture risk. Sufficient data are lacking regarding cortical bone microarchitecture and bone strength, as assessed by micro-finite element analysis (µFEA). OBJECTIVE: To elucidate both cortical and trabecular bone microarchitecture and estimated bone strength in men with active acromegaly or GHD compared to healthy controls. DESIGN AND SUBJECTS: Cross-sectional study at a clinical research center, including 48 men (16 with acromegaly, 16 with GHD and 16 healthy controls)...
August 5, 2017: European Journal of Endocrinology
C Rochette, F Castinetti, T Brue
Acromegaly and Cushing's disease lead to common and distinct comorbidities. Currently available treatments lead to the control of hyper secretion in the majority of cases. However, the prevalence of the comorbidities does not always go back to the one of the normal population after remission. For instance, about 1/3 of acromegalic patients with diabetes and half of patients with Cushing's disease and diabetes will have normal blood glucose values after remission. In contrast, high blood pressure frequently recovers after remission in both diseases...
October 2016: Annales D'endocrinologie
Régis Coutant, Aurélie Donzeau, Anne Decrequy, Mathilde Louvigné, Natacha Bouhours-Nouet
The diagnostic approach to tall stature in children is based on collecting birth data (macrosomia), sizes and family puberty, a family history of constitutional or pathological tall stature, search for a delay of development, dysmorphia, disproportion, analysis of the growth velocity (normal or accelerated), general examination and assessment of puberty, and bone age. When there is a history of psychomotor retardation, a family history of pathological tall stature, or a disproportion in the clinical examination, the genetic causes of tall stature will be mentioned...
May 5, 2017: Annales D'endocrinologie
Ruth Mangupli, Adrian F Daly, Elvia Cuauro, Paul Camperos, Jaime Krivoy, Albert Beckers
SUMMARY: A 20-year-old man with an 8-year history of progressive enlargement of his hands and feet, coarsening facial features, painful joints and thickened, oily skin was referred for investigation of acromegaly. On examination, the subject was of normal height and weight. He had markedly increased skin thickness around the forehead, eyelids and scalp with redundant skin folds. Bilateral painful knee swelling was accompanied by enlargement of the extremities, and his fingers were markedly clubbed...
2017: Endocrinology, Diabetes & Metabolism Case Reports
Tina Constantin, Vin Tangpricha, Reshma Shah, Nelson M Oyesiku, Octavian C Ioachimescu, James Ritchie, Adriana G Ioachimescu
Context: Acromegaly has been associated with calcium-phosphate and bone turnover alterations. Controlled studies of these interactions are sparse. Objective: To evaluate calcium and bone metabolism in active and treated acromegaly. Design/Setting/Patients: We conducted a controlled prospective study at a tertiary referral center. We studied 22 patients with acromegaly referred for surgical or medical therapy (ACM) and 22 with nonfunctioning pituitary adenomas referred for surgery (control)...
April 12, 2017: Journal of Clinical Endocrinology and Metabolism
K M J A Claessen, A Navas Canete, P W de Bruin, A M Pereira, M Kloppenburg, H M Kroon, N R Biermasz
BACKGROUND: Arthropathy is a prevalent and invalidating complication of acromegaly with a characteristic radiographic phenotype. We aimed to further characterize cartilage and bone abnormalities associated with acromegalic arthropathy using magnetic resonance imaging (MRI). METHODS: Twenty-six patients (23% women, mean age 56.8 ± 13.4 years), with active (n = 10) and controlled acromegaly (n = 16) underwent a 3.0 T MRI of the right knee. Osteophytes, cartilage defects, bone marrow lesions and subchondral cysts were assessed by the Knee Osteoarthritis Scoring System (KOSS) method...
June 2017: European Journal of Endocrinology
Gian Paolo Fadini, Francesca Dassie, Roberta Cappellari, Mariasara Persano, Saula Vigili de Kreutzenberg, Chiara Martini, Matteo Parolin, Angelo Avogaro, Roberto Vettor, Pietro Maffei
Context: Acromegaly is a systemic disease characterized by persistent bone pathology and excess cardiovascular mortality. Despite multiple concomitant risk factors, atherosclerosis does not seem to be accelerated in acromegaly. Objective: To compare the levels of circulating myeloid calcifying cells (MCCs), which promote ectopic calcification and inhibit angiogenesis, in individuals with and without acromegaly. Design: Cross-sectional case-control study...
June 1, 2017: Journal of Clinical Endocrinology and Metabolism
F Malgo, N A T Hamdy, T J Rabelink, H M Kroon, K M J A Claessen, A M Pereira, N R Biermasz, N M Appelman-Dijkstra
OBJECTIVE: Acromegaly is a rare disease caused by excess growth hormone (GH) production by the pituitary adenoma. The skeletal complications of GH and IGF-1 excess include increased bone turnover, increased cortical bone mass and deteriorated microarchitecture of trabecular bone, associated with a high risk of vertebral fractures in the presence of relatively normal bone mineral density (BMD). We aimed to evaluate tissue-level properties of bone using impact microindentation (IMI) in well-controlled patients with acromegaly aged ≥18 years compared to 44 controls from the outpatient clinic of the Centre for Bone Quality...
March 2017: European Journal of Endocrinology
S Tuzcu, Ş A Durmaz, A Carlıoğlu, Z Demircan, A Tuzcu, C Beyaz, A Tay
OBJECTIVE: Growth hormone (GH) and insulin-like growth factor-1 (IGF-1) play a major role in bone homeostasis. In this study, we aimed to assess bone mineral density (BMD) in active acromegaly. MATERIALS AND METHODS: A total of 29 patients with active acromegaly (age 46.10 ± 13.27 years; body mass index [BMI]: 29.51 ± 4.91 kg/m(2)) and 42 healthy individuals matched for age and BMI (age: 40.35 ± 11.74 years; BMI: 28.18 ± 7.35 kg/m(2)) were included in the study...
October 20, 2016: Zeitschrift Für Rheumatologie
Connie Y Chang, Daniel I Rosenthal, Deborah M Mitchell, Atsuhiko Handa, Susan V Kattapuram, Ambrose J Huang
Metabolic bone diseases are a diverse group of diseases that result in abnormalities of (a) bone mass, (b) structure mineral homeostasis, (c) bone turnover, or (d) growth. Osteoporosis, the most common metabolic bone disease, results in generalized loss of bone mass and deterioration in the bone microarchitecture. Impaired chondrocyte development and failure to mineralize growth plate cartilage in rickets lead to widened growth plates and frayed metaphyses at sites of greatest growth. Osteomalacia is the result of impaired mineralization of newly formed osteoid, which leads to characteristic Looser zones...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
G Mazziotti, F Maffezzoni, S Frara, A Giustina
Acromegalic osteopathy is an emerging complication of acromegaly characterized by increase in bone turnover, deterioration in bone microarchitecture and high risk of vertebral fractures. Vertebral fractures, as diagnosed by a radiological and morphometric approach, occur in about one-third of acromegaly patients in close relationship with duration of active disease. However, the prediction of vertebral fractures in this clinical setting is still a matter of uncertainty, since the pathogenesis of acromegalic osteopathy is multifactorial and fractures may occur even in presence of normal bone mineral density...
February 2017: Pituitary
Filippo Maffezzoni, Michele Maddalo, Stefano Frara, Monica Mezzone, Ivan Zorza, Fabio Baruffaldi, Francesco Doglietto, Gherardo Mazziotti, Roberto Maroldi, Andrea Giustina
Vertebral fractures are an emerging complication of acromegaly but their prediction is still difficult occurring even in patients with normal bone mineral density. In this study we evaluated the ability of high-resolution cone-beam computed tomography to provide information on skeletal abnormalities associated with vertebral fractures in acromegaly. 40 patients (24 females, 16 males; median age 57 years, range 25-72) and 21 healthy volunteers (10 females, 11 males; median age 60 years, range: 25-68) were evaluated for trabecular (bone volume/trabecular volume ratio, mean trabecular separation, and mean trabecular thickness) and cortical (thickness and porosity) parameters at distal radius using a high-resolution cone-beam computed tomography system...
November 2016: Endocrine
Audrey E Arzamendi, Kiarash Shahlaie, Richard E Latchaw, Mirna Lechpammer, Hasmik Arzumanyan
OBJECTIVE: To describe the work-up and treatment of rare ectopic acromegaly caused by a biopsy-proven somatotroph pituitary adenoma located within the bony intersphenoid septum of a patient with empty sella syndrome (ESS). METHODS: We report the presentation, clinical course, diagnostic work-up, and lesion localization and treatment challenges encountered in a 55-year-old patient, with a brief review of relevant literature. RESULTS: A 55-year-old African-American man presented with acromegaly and ESS...
July 2016: Journal of Neurological Surgery Reports
Christina Dimopoulou, Sarah M Leistner, Marcus Ising, Harald J Schneider, Jochen Schopohl, Sandra Rutz, Robert Kosilek, Richard Frohner, Gunter K Stalla, Caroline Sievers
OBJECTIVE: Diagnosis of acromegaly is delayed up to 10 years after disease onset despite obvious external/objective changes such as bone and soft tissue deformities. We hypothesized that a lack of subjective perception of the disease state, possibly mediated by psychiatric or cognitive alterations, might contribute to the delayed initiation of a diagnostic workup. DESIGN: Cross-sectional study. METHODS: We investigated perceived body image by standardized questionnaires (FKB-20: Fragebogen zum Körperbild; FBeK: Fragebogen zur Beurteilung des eigenen Körpers) in 81 acromegalic patients and contrasted them to (a) a clinical control group of 60 patients with nonfunctioning pituitary adenomas (NFPA) who lack severe facial and physical alterations and (b) healthy controls...
2017: Neuroendocrinology
Kristin Godang, Nicoleta Cristina Olarescu, Jens Bollerslev, Ansgar Heck
CONTEXT: Bone turnover is increased in acromegaly. Despite normalization of bone turnover after treatment, the risk for vertebral fractures remains increased. Gonadal status, but not BMD, is correlated with vertebral fractures. Trabecular bone score (TBS) is related to bone microarchitecture. OBJECTIVE: The aim of this study is to assess the longitudinal change in TBS and BMD following treatment for acromegaly. DESIGN, SETTING, PATIENTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: This longitudinal study included 48 patients with acromegaly between 2005 and 2015...
August 2016: European Journal of Endocrinology
T Rubinek, D Modan-Moses
The growth hormone (GH)/insulin-like growth factor (IGF)-1 axis is pivotal for many metabolic functions, including proper development and growth of bones, skeletal muscles, and adipose tissue. Defects in the axis' activity during childhood result in growth abnormalities, while increased secretion of GH from the pituitary results in acromegaly. In order to keep narrow physiologic concentration, GH and IGF-1 secretion and activity are tightly regulated by hypothalamic, pituitary, endocrine, paracrine, and autocrine factors...
2016: Vitamins and Hormones
Nicholas A Tritos, Anne Klibanski
PURPOSE: Describe the effects of growth hormone (GH) and insulin-like growth factor 1 (IGF-1) on the skeleton. FINDINGS: The GH and IGF-1 axis has pleiotropic effects on the skeleton throughout the lifespan by influencing bone formation and resorption. GH deficiency leads to decreased bone turnover, delayed statural growth in children, low bone mass, and increased fracture risk in adults. GH replacement improves adult stature in GH deficient children, increases bone mineral density (BMD) in adults, and helps to optimize peak bone acquisition in patients, during the transition from adolescence to adulthood, who have persistent GH deficiency...
2016: Progress in Molecular Biology and Translational Science
Stefano Frara, Filippo Maffezzoni, Gherardo Mazziotti, Andrea Giustina
Acromegaly is an insidious disorder characterized by excess secretion of growth hormone (GH) and elevated circulating levels of insulin-like growth factor-I (IGF-I), generally caused by a pituitary adenoma. It is a rare disease associated with an average 10-year reduction in life expectancy due to metabolic, cardiovascular, and cerebrovascular comorbidities and reduced quality of life caused by paresthesias, fatigue, osteoarthralgia, or bone fractures. In 2000, Cortina Consensus Conference established general criteria for diagnosis and biochemical control of acromegaly, which have been revised in recent years, adapting them to emerging clinical evidences as well as the evolving assay techniques...
2016: Progress in Molecular Biology and Translational Science
Hande Mefkure Ozkaya, Nil Comunoglu, Fatma Ela Keskin, Buge Oz, Ozlem Asmaz Haliloglu, Necmettin Tanriover, Nurperi Gazioglu, Pinar Kadioglu
Aromatase, a key enzyme in local estrogen synthesis, is expressed in different pituitary tumors including growth hormone (GH)-secreting adenomas. We aimed to evaluate aromatase, estrogen receptor α (ERα), estrogen receptor β (ERβ), pituitary tumor transforming gene (PTTG), and fibroblast growth factor 2 (FGF2) expressions in GH-secreting adenomas, and investigate their correlation with clinical, pathologic, and radiologic parameters. This cross-sectional study was conducted in a tertiary center in Turkey...
June 2016: Endocrine
Elena Valassi, Iris Crespo, Jorge Malouf, Jaume Llauger, Anna Aulinas, Ana Maria Marín, Betina Biagetti, Susan M Webb
OBJECTIVE: Data on dual energy absorptiometry (DXA)-measured bone mineral density (BMD) at the level of the total hip (TH) and femoral neck (FN) in patients with acromegaly (ACRO) are conflicting. Increase in bone size associated with ACRO may limit the reliability of DXA. Our objective is to evaluate trabecular and cortical volumetric BMD (vBMD) across the proximal femur in ACRO patients. DESIGN: Cross sectional study in a clinical research center. PATIENTS: Thirty-five ACRO patients (19 males; mean age, 48±7 years; BMI, 27...
February 2016: European Journal of Endocrinology
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