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Acromegaly and joint pain: is there something more? A cross-sectional study to evaluate rheumatic disorders in growth hormone secreting tumor patients

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Abstract

Purpose

The aim of the present study was to evaluate the rheumatic profile in acromegalic patients to better characterize joint pain.

Methods

The immunological pattern (rheumatoid factor; antinuclear antibodies—ANA, extractable nuclear antigens—ENA-Ab; anti-citrullinated protein antibodies; erythrocyte sedimentation rate) was evaluated in 20 acromegaly subjects (AS) and 20 control subjects (CS). Bilateral joint ultrasound of hands/wrists and nail capillaroscopy were also performed.

Results

Articular pain was more frequent in AS than in CS (p = 0.027). No difference was detected in immunological parameters. ANA and ENA-Ab were positive in only 10% of AS and in 5% of CS, while no difference was found in anti-citrullinated protein antibodies. No difference was detected between rheumatoid factor positivity, but threefold higher IgG were detected in AS compared to CS. The erythrocyte sedimentation rate was significantly higher in AS than CS (p = 0.040), while in AS, there was a trend in increased Power Doppler (PWD) articular uptake. The capillaroscopic evaluation showed a significant difference in almost each parameter (presence and number of tortuous capillaries, capillary enlargements, and hemorrhages), showing a moderate-to-severe microangiopathy in AS.

Conclusion

The results of our study suggest that joint damage in acromegaly has not an autoimmune etiology. Increased erythrocyte sedimentation rate levels and PWD alteration in acromegalic population reflect a possible inflammatory nature, while the capillaroscopic findings suggest a moderate-to-severe microangiopathy that could help to identify patients with a greater macroangiopathic risk.

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Acknowledgements

The authors would like to thank Ezio Ghigo for his scientific contribution and constructive recommendations on this project and Valeria Cambria and Filippo Gatti for helping with patient enrollment.

Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

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Author notes

  1. N. Prencipe and M. Scarati have contributed equally to this work.

Authors and Affiliations

  1. Division of Endocrinology, Diabetology and Metabolism, Department of Medical Science, University of Turin, Corso Dogliotti 14, 10126, Turin, Italy

    N. Prencipe, A. M. Berton, C. Bona, M. Parasiliti-Caprino, V. Gasco & S. Grottoli

  2. SSD of Rheumatology, Medical Department, Mauriziano Hospital, Turin, Italy

    M. Scarati

  3. Department of Public and Pediatric Health, AOU Health and Science City, Turin, Italy

    T. Manetta

  4. SC of Rheumatology, Medical Department, AOU Health and Science City, Turin, Italy

    S. Parisi, M. C. Ditto & E. Fusaro

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  1. N. Prencipe
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Correspondence to N. Prencipe.

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All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All patients filled informed consent statement for this study.

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Prencipe, N., Scarati, M., Manetta, T. et al. Acromegaly and joint pain: is there something more? A cross-sectional study to evaluate rheumatic disorders in growth hormone secreting tumor patients. J Endocrinol Invest 43, 1661–1667 (2020). https://doi.org/10.1007/s40618-020-01268-8

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  • DOI: https://doi.org/10.1007/s40618-020-01268-8

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