Symptoms and signs of acromegaly: an ongoing need to raise awareness among healthcare practitioners
Redzuan Zarool-Hassan 1 , Helen M. Conaglen 2 , John V. Conaglen 2 , Marianne S. Elston 1 2 31 Department of Endocrinology, Waikato Hospital, Private Bag 3200, Hamilton, New Zealand
2 Waikato Clinical Campus, University of Auckland, Hamilton 3240, New Zealand
3 Correspondence to: Dr Marianne S Elston, Department of Endocrinology, Waikato Hospital, Private Bag 3200, Hamilton 3240, New Zealand. Email: Marianne.Elston@waikatodhb.health.nz
Journal of Primary Health Care 8(2) 157-163 https://doi.org/10.1071/HC15033
Published: 30 June 2016
Journal Compilation © Royal New Zealand College of General Practitioners 2016.
This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Abstract
INTRODUCTION: Chronic excess growth hormone production results in acromegaly, a condition associated with widespread physical changes, including soft tissue and bony overgrowth. When untreated, acromegaly reduces life expectancy. Patients usually remain undiagnosed for years after the onset of symptoms, by which stage irreversible physical changes have often occurred.
METHOD: A cross-sectional questionnaire study involving patients with acromegaly from the Waikato Endocrine Unit and the New Zealand Acromegaly Society evaluated features of acromegaly that were present before diagnosis. The aim of this study was to identify acromegaly features that were most prevalent to promote increased awareness about the disease by healthcare providers.
RESULTS: 81 participants were included. The main pre-diagnosis physical changes participants reported were acral changes, alterations in facial features and oral symptoms. For some, these features were present for more than 10 years before the acromegaly diagnosis. Multiple co-morbidities associated with acromegaly were reported. Two-thirds of the participants felt that an earlier diagnosis was possible. Most participants were in contact with General Practitioners (GPs) and/or dentists before diagnosis. Endocrinologists had the highest diagnosis rate, followed by GPs. Dentists had a low diagnosis rate despite a high prevalence of oral symptoms among study participants.
CONCLUSION: Increased awareness of acromegaly among primary care clinicians is important as they are the first-point-of-contact with the healthcare system for most patients. Health professionals’ early recognition of symptoms and signs of acromegaly would reduce delays in time-to-diagnosis, enable earlier treatment and may improve outcomes for patients with acromegaly.
MESH KEYWORDS: Acromegaly; symptoms; delayed diagnosis; clinicians; primary healthcare
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