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Respiratory Dysfunctions in Acromegaly. Acromegaly and Sleep Apnea

Denis Veliev, Adem Hadjimehmed, Svilena Rangelova, Mukates Velieva, Evelina Zlatanova-Kazakova

Abstract

Introduction: Acromegaly refers to an abnormal growth of some bones and tissues due to excessive action of insulin-like growth factor-1 (IGF-1). It occurs after the growth plate cartilage fuses in adulthood. Acromegaly is an insidious disease, which is often diagnosed late in its course. The diagnosis is often preceded by around 10 years of active but unrecognized disease. The most frequent clinical manifestations of acromegaly affect the skin and joints. Patients with acromegaly are also at increased risk of cardiovascular, cerebrovascular and respiratory disorders, and a development of neoplastic lesions.

Materials and Methods: Prof. Francesco Cavagnini, MD, PhD (ITA), Dr. Mark Gurnell (UK) and Dr. Eve van Cauter (US)’s studies have revealed high prevalence of many different respiratory problems among patients with acromegaly. The aim of the present report is to focus on the life-threatening conditions that acromegaly causes and the importance of early diagnosis. Camilo et al. 2013 (Brazilian scientists) compared 20 acromegaly patients with 20 healthy controls. The results showed extensive alterations in respiratory functions in patients with acromegaly.

Results: The findings in this study showed a significant decrease of the functional capability of the respiratory system. Bronchiectasis was found in 35% of acromegaly patients and almost every patient had an obstructive type of sleep apnea.  Dr. M. Gurnell and Dr. E. van Cauter found similar results in their studies. Additionally, they revealed that 4 out of 5 acromegaly patients experienced severe sleep apnea. This condition leads to higher risk of mortality as it induces a number of metabolic derangements such as arterial hypertension, metabolic syndrome and diabetes, making the occurrence of cardiovascular events more frequent. 

Conclusion: Respiratory disorders related to acromegaly appear to be complex in their origin and development. Furthermore, they appear as two main respiratory dysfunctions, being sleep apnea and impaired respiratory function. It is important for the patients to be diagnosed at the early stages of the disease, in order to be able to receive an adequate treatment for respiratory disorders.


Keywords

acromegaly, respiratory disorder, sleep apnea, growth hormone, diagnosis


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