Avaliação da morfologia e função tireoidiana nos pacientes acromegálicos atendidos no Centro de Especialidades Médicas do CESUPA (CEMEC)

Abstract

Introduction: Acromegaly is a chronic and multisystemic desease, has an insidious onset, and is debilitating. Results from hypersecretion of Growth Hormone and Insulin Growth Factor. The mortality rate is up to 3.5 times larger than the unaffected population due to mainly associated comorbidities and the late character of its diagnosis. Among the proved associations, it’s important to give attention to thyroid functional modifications and it’s morphology, due to evolution of these modifications until the appearance of thyroid neoplasms. Objective: Evaluate thyroid morphology and thyroid functional disorders in acromegalic patients attended at the “Centro de Especialidades Médicas (CEMEC) – CESUPA”, on the Pituitary and Adrenal abulatory. Methodology: Epidemiological, cross-sectional and retrospective study. Data were collected from the acromegalics patient’s medical records, enrolled at the Pituitary and Adrenal abulatory, at CEMEC until June 2019, with a total of 59 patients. Results: Most of the acromegalic patients treated at CEMEC presented pituitary macroadenoma (83.1%) in the initial evaluation. Among the altered laboratory results of TSH (first evaluation 17 and last evaluation 7), the majority presented values below normal in both the first (n = 15) and the last evaluation (n = 6). Thyroxine altered values were also analyzed (first evaluation n=10 and last evaluation n=8), and there was a higher occurrence of results below normality in the first evaluation (n = 7) and equality between values below and above normality in the final evaluation, however without statistically significant results (p = 0.9849). Evaluating the presence of thyroid nodules with gender and time of disease, there was no statistically significant difference (respectively p = 0.9426 and p = 0.4115), however, the relation was significant when related to age group, with a higher frequency between 70 and 79 years. years old (* p = 0.0435). Furthermore, it was evidenced that there was no statistically significant relation between the IGF-1 LSN values and the occurrence of thyroid nodules in the first and final evaluations (respectively p = 0.5834 and p = 0.9514). There was also no statistically significant relationship when analyzing mean GH values and nodule occurrence at the first and last assessment (p = 0.7197 and 0.6831).Conclusion: In the thyroid ultrasonography, most of the nodules found in the first and final evaluation had the following characteristics: localization in the right, single, hypoechoic sludge, with solid content and regular contours. The characteristics found weren’t suggestive of malignancy. Although acromegaly treatment control is unrelated to the occurrence of nodules, it is extremely important to follow up these possible modifications to improve the life expectancy of these patients and the early detection of potentially malignant lesions.