Document Detail


Goiter and impairment of thyroid function in acromegalic patients: basal evaluation and follow-up.
MedLine Citation:
PMID:  10871160     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: We evaluated morphological, biochemical and cytological thyroid parameters in acromegalic patients, investigated before and after treatment for acromegaly. PATIENTS: 28 acromegalics were investigated before and, in 18 cases, after 2-7 years of therapy. Fourteen patients were from areas of moderate iodine deficiency in Southern Italy. One patient underwent thyroidectomy before entering this study. RESULTS: 19 patients were euthyroid (FT4: 17.7 +/- 0.8 pmol/l and FT3 4.6 +/- 0.2 pmol/l), but TSH was undetectable in 5/19. Among them, TRH-stimulated TSH increase was absent/impaired or exaggerated/delayed in 9 and one cases, respectively. Decreased FT3 and/or FT4 values with low/normal TSH values were detected in 7 cases; TRH-stimulated TSH response was absent/impaired in 2 patients and exaggerated/delayed in another two. Increased free T4 and free T3 concentrations with undetectable TSH levels were found in one. Two euthyroid patients had high TPOAb levels. Goiter was diagnosed in 21 cases and nodules were found in 14/21. 99Tc scintiscan showed "cold" areas in 13/14 cases and a "hot" nodule in the hyperthyroid patient. Acromegalics from iodine deficient areas showed a not significant increase of prevalence of goiter (86 vs. 71 %) and of mean thyroid volume (35 +/- 7 vs. 28 +/- 4 ml, NS), compared to others. Thyroid volume (TV) did not correlate with GH, IGF-1 and TSH levels, the area under the curve of insulin-increase during OGTT, the age of patients or the duration of acromegaly. Fine needle aspiration biopsy (FNAB), performed in 11/14 patients with nodular goiter, showed colloid nodules in 8 cases, hyperplastic nodules in 2 and an adenomatous nodule in one. Neurosurgery, radiotherapy or medical treatment for acromegaly induced a significant decrease of mean GH and IGF-1 levels (21.5 +/- 8.5 vs. 12.9 +/- 9.6 ng/ml, p< 0.005 and 747 +/- 94 vs. 503 +/- 88 ng/ml, p < 0.02, respectively), but both GH and IGF-1 values normalized only in 3 cases. No significant variation of mean TSH levels was found. Although TV normalized in 3 patients, ultrasound evaluation showed a not significant decrease of mean TV and no changes in the diameter and number of nodules. FNAB was unchanged. CONCLUSIONS: Our results suggest that, despite no correlation between serum GH and IGF-1 levels and thyroid volume being found, a decrease in serum GH and IGF-1 levels has favourable effects on thyroid status.
Authors:
S Cannavò; S Squadrito; M D Finocchiaro; L Curtò; B Almoto; A Vieni; F Trimarchi
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et métabolisme     Volume:  32     ISSN:  0018-5043     ISO Abbreviation:  Horm. Metab. Res.     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-09-26     Completed Date:  2000-09-26     Revised Date:  2009-02-19    
Medline Journal Info:
Nlm Unique ID:  0177722     Medline TA:  Horm Metab Res     Country:  GERMANY    
Other Details:
Languages:  eng     Pagination:  190-5     Citation Subset:  IM    
Affiliation:
Cattedra di Endocrinologia, University of Messina, Italy. endocrinologi@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Acromegaly / complications*,  etiology,  pathology*
Adenoma / complications
Adult
Aged
Biopsy
Female
Follow-Up Studies
Goiter / etiology*,  pathology*
Growth Hormone / blood
Humans
Insulin-Like Growth Factor I / metabolism
Iodine / deficiency
Male
Middle Aged
Pituitary Neoplasms / complications
Thyroid Function Tests
Thyroid Gland / pathology,  physiology*
Thyrotropin / blood
Chemical
Reg. No./Substance:
67763-96-6/Insulin-Like Growth Factor I; 7553-56-2/Iodine; 9002-71-5/Thyrotropin; 9002-72-6/Growth Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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