Alʹmanah Kliničeskoj Mediciny (Sep 2016)
Upper and lower gastrointestinal tract disorders in patients with newly diagnosed acromegaly
Abstract
Background: Increased growth hormone production in acromegaly results in enlargement of inner organs, their dysfunction and morphological abnormalities. Of special interest are patients with newly diagnosed acromegaly, because their gastrointestinal mucosa can be assessed without consideration of the influence of medications used for the treatment of the underlying disorder. Aim: To describe characteristic features of upper and lower gastrointestinal tract disorders in patient with treatment-naive acromegaly. Materials and methods: We examined 37 patients with newly diagnosed acromegaly, aged from 22 to 73 years (mean age, 49.9 ± 2.1 years). All patients underwent esophagogastroduodenoscopy with biopsy for identification of Helicobacter pylori, colonoscopy, morphological examination of biopsy samples taken from neoplasms of the upper gastrointestinal tract, as well as of the colon. The control group included 35 individuals without acromegaly who were ageand gender compatible with the patients of the main group. Results: Cardiac insufficiency was diagnosed in 23 patients with acromegaly and in 13 in the control group (p < 0.05), simultaneous lesions of the stomach and duodenal bulb (erosions), in 7 and 2 patients, respectively (p > 0.05), gastric polypoids, in 6 patients of the main group and in no patient from the control group (p < 0.05). There were no significant differences between groups on esophagitis Savary Miller Grade 1 and 2 (grading, Grade 1 in 7 and 5 patients and Grade 2 in 3 and 2, respectively), as well as on contamination with Helicobacter pylori (19 patients in each of the groups). Colon abnormalities were found in patients with acromegaly more frequently than in the control group: dolichosigma, in 12 and 4 (p < 0.05), colonic polyps, in 13 and 2, respectively (p < 0.01). Diverticles were found in 9 with acromegaly and in 3 in the control group (p > 0.05). At histological examination, hyperplastic gastric polyps were found only in patients with acromegaly (6 patients, p < 0.05), colonic polyps in 8 patients from the main group and in 2 from the control one (p > 0.05). Tubular adenomas were diagnosed only in patients with acromegaly, in 2 of them they were located in the stomach (p > 0.05) and in 5, in the colon (p < 0.05). Conclusion: Right from the diagnosis, patients with acromegaly should undergo an examination of upper and lower gastrointestinal tract, because of the high probability of various disorders under high production of the growth hormone.
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