Acromegaly and joint pain: is there something more? A cross-sectional study to evaluate rheumatic disorders in growth hormone secreting tumor patients
- 1 November 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Journal of Endocrinological Investigation
- Vol. 43 (11), 1661-1667
- https://doi.org/10.1007/s40618-020-01268-8
Abstract
Purpose The aim of the present study was to evaluate the rheumatic profile in acromegalic patients to better characterize joint pain. Methods The immunological pattern (rheumatoid factor; antinuclear antibodies-ANA, extractable nuclear antigens-ENA-Ab; anti-citrullinated protein antibodies; erythrocyte sedimentation rate) was evaluated in 20 acromegaly subjects (AS) and 20 control subjects (CS). Bilateral joint ultrasound of hands/wrists and nail capillaroscopy were also performed. Results Articular pain was more frequent in AS than in CS (p = 0.027). No difference was detected in immunological parameters. ANA and ENA-Ab were positive in only 10% of AS and in 5% of CS, while no difference was found in anti-citrullinated protein antibodies. No difference was detected between rheumatoid factor positivity, but threefold higher IgG were detected in AS compared to CS. The erythrocyte sedimentation rate was significantly higher in AS than CS (p = 0.040), while in AS, there was a trend in increased Power Doppler (PWD) articular uptake. The capillaroscopic evaluation showed a significant difference in almost each parameter (presence and number of tortuous capillaries, capillary enlargements, and hemorrhages), showing a moderate-to-severe microangiopathy in AS. Conclusion The results of our study suggest that joint damage in acromegaly has not an autoimmune etiology. Increased erythrocyte sedimentation rate levels and PWD alteration in acromegalic population reflect a possible inflammatory nature, while the capillaroscopic findings suggest a moderate-to-severe microangiopathy that could help to identify patients with a greater macroangiopathic risk.This publication has 21 references indexed in Scilit:
- Current perspectives on the impact of clinical disease and biochemical control on comorbidities and quality of life in acromegalyReviews in Endocrine and Metabolic Disorders, 2019
- Ultrasound power Doppler and gray scale joint inflammation: What they reveal in rheumatoid arthritisInternational Journal of Rheumatic Diseases, 2019
- Use of administrative health databases to estimate incidence and prevalence of acromegaly in Piedmont Region, ItalyJournal of Endocrinological Investigation, 2018
- Capillaroscopy in Routine Diagnostics: Potentials and LimitationsCurrent Rheumatology Reviews, 2018
- Is every joint symptom related to acromegaly?Endocrine, 2012
- Nail-fold capillary abnormalities are associated with anti-centromere antibody and severity of digital ischaemiaRheumatology, 2010
- Rheumatoid arthritis masquerading as acromegaly recurrence: report of two casesRheumatology International, 2010
- High prevalence of arthropathy, according to the definitions of radiological and clinical osteoarthritis, in patients with long-term cure of acromegaly: a case–control studyActa Endocrinologica, 2009
- Autoantibodies and microvascular damage are independent predictive factors for the progression of Raynaud's phenomenon to systemic sclerosis: A twenty‐year prospective study of 586 patients, with validation of proposed criteria for early systemic sclerosisArthritis & Rheumatism, 2008
- Acromegalic arthropathy.Annals Of The Rheumatic Diseases, 1971