Rheumatic manifestations of acromegaly

Taras S. Panevin; Lyudmila I. Alekseeva; Galina A. Melnichenko

Rheumatic manifestations of acromegaly

Taras S. Panevin, Lyudmila I. Alekseeva, Galina A. Melnichenko

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Abstract

Acromegaly is a chronic endocrine disease characterized by excessive secretion of growth hormone (GH), which, in turn, leads to increased insulin-like growth factor 1 (IGF-1) secretion by the liver. GH and IGF-1 excess leads to excessive cell and tissue growth, including the osteoarticular apparatus. Joint pain in acromegaly is a frequent and early symptom. In some cases, joint manifestations can be one of the first signs of acromegaly and their intensity increases with duration of the active disease. Estimated prevalence of joint damage signs is around 70% of patients at the time of diagnosis of acromegaly. Musculoskeletal system alterations can manifest either in axial skeleton and peripheral joints. Besides arthropathy, patients with acromegaly (both active and controlled) are more prone to vertebral fractures, although it was previously thought that acromegaly has a low risk of osteoporosis. In this article, we review features of damage to the axial skeleton, peripheral joints in the setting of excessive GH and IGF-1 production, as well as the association of autoimmune rheumatic diseases and acromegaly.

Keywords

acromegaly, arthropathy, insulin-like growth factor 1, osteoarthritis, joints, osteoporosis

About the Authors

Taras S. Panevin

V.A. Nasonova Research Institute of Rheumatology; Endocrinology Research Centre
Russian Federation

Lyudmila I. Alekseeva

V.A. Nasonova Research Institute of Rheumatology
Russian Federation

MD, PhD

Galina A. Melnichenko

Endocrinology Research Centre
Russian Federation

MD, PhD, Professor

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Supplementary files

	1. Fig. 1. The expansion of the joint gap on the background of severe osteophytosis in a patient with acromegaly born in 1947
	Subject
	Type	Other
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	2. Fig. 2. Calcification of the anterior longitudinal ligament and reduction of disk space in a patient born in 1954 with acromegaly.
	Subject
	Type	Other
	View (358KB)	Indexing metadata ▾

	3. Fig. 3. Pronounced calcification of the anterior longitudinal ligament of the thoracic and lumbar spine, mainly on the right in a patient born in 1960 with acromegaly.
	Subject
	Type	Other
	View (180KB)	Indexing metadata ▾

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Panevin T.S., Alekseeva L.I., Melnichenko G.A. Rheumatic manifestations of acromegaly. Osteoporosis and Bone Diseases. 2019;22(2):14-22. (In Russ.)

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	Title	Fig. 1. The expansion of the joint gap on the background of severe osteophytosis in a patient with acromegaly born in 1947
	Date	2019-11-21

	Title	Fig. 2. Calcification of the anterior longitudinal ligament and reduction of disk space in a patient born in 1954 with acromegaly.
	Date	2019-11-21

	Title	Fig. 3. Pronounced calcification of the anterior longitudinal ligament of the thoracic and lumbar spine, mainly on the right in a patient born in 1960 with acromegaly.
	Date	2019-11-21

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Osteoporosis and Bone Diseases

Rheumatic manifestations of acromegaly

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