말단 비대증 증상 징후 What are some of the clinical features of acromegaly?

말단 비대증 증상 징후 What are some of the clinical features of acromegaly?

NEJM 3/5/2020 에서 온글

Approximately 70% of patients with acromegaly have an invasive macroadenoma at diagnosis. Coexisting conditions include headache and insidious acral and soft-tissue changes. The diagnosis of acromegaly can be delayed by a mean of approximately 10 years after the onset of symptoms. Patients may first seek dental, orthopedic, rheumatologic, or cardiac care. In one study, approximately 20% of 324 patients sought care because of an altered facial appearance, enlarged extremities, or both. Other features include increased shoe or ring size, voice deepening, the carpal tunnel syndrome, hyperhidrosis, and frontal-skull bossing and coarse oily skin. Prognathism leads to incisor separation and jaw malocclusion. Obstructive sleep apnea and excessive snoring are hallmarks of uncontrolled acromegaly. Arthropathy is reported in approximately 70% of patients, with polyarticular arthritis, osteophytosis, dorsal kyphosis, and vertebral fractures. Coexisting cardiovascular conditions include hypertension, arrhythmias, and left ventricular dysfunction, with an increased aortic-root diameter.