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Dr. Samson:
This is CME on ReachMD, and I’m Dr. Susan Samson. Here with me today is my colleague, Dr. Kevin Yuen.

Let’s dive right in with a discussion of the importance of recognizing acromegaly and the impact of a delayed diagnosis and how it affects our patients.

Dr. Yuen, what are some of the challenges for identifying and diagnosing patients with acromegaly?

Dr. Yuen:
Thank you, Dr. Samson, for your question. The major challenges of diagnosing acromegaly is the fact that many of these symptoms can be very subtle, and they take time to manifest themselves, and not one patient can have similar symptoms. Every patient can have different symptoms. For example, some patients may complain of things like acro-enlargement or maybe a slight enlargement in their hands and feet. Some patients may complain of headaches, sweating, menstrual disorders in women, carpal tunnel syndrome. Some patients may develop a very common condition like high blood pressure or diabetes. And also sleep apnea is another common presentation. So these symptoms, not only do they take time to present themselves and can be quite subtle in some patients, they also could be very common symptoms, symptoms that many primary care physicians see in their clinical practice which may not necessarily lead them to think that the patient has underlying acromegaly and it’s manifesting some of these signs and symptoms.

So I think that is an important thing, and then secondly, when it comes to signs, again, that also takes time to develop, and patients may not necessarily know or be aware, especially themselves and also their partners or their loved ones, because they see them so often. So these minor changes may not be too apparent to the person who sees them almost every day. And that is really the major challenge of getting the diagnosis early. But if you are able to find the cause and the diagnosis and diagnose a patient early, I think the benefits are actually good for the patient because then you could initiate treatment early, and that will hopefully reduce the time for comorbidities to develop. And as you know, growth hormone affects many organs in the body, and as a result, the many organs can be affected. Many comorbidities can be affected, and diagnosing them early and giving the appropriate treatment early is – I can’t emphasize – is extremely important.

And so I think, for a comprehensive diagnosis, once one has diagnosed acromegaly, I think it’s important to also clearly look for any other changes or any other comorbidities because acromegaly can be associated with other comorbidities, and one needs to treat them if these comorbidities are present, for example, hypertension, diabetes, sleep apnea. So these are very important things that should not be missed, in addition to treating the acromegaly itself.

Dr. Samson:
Yeah, thank you for that, and I agree that it is so important that we diagnose our patients in a timely fashion because we know that that delayed diagnosis can lead to increased comorbidities. For example, some colleagues of ours had published a paper from Sweden showing that the longer the delay in diagnosis, the more the number of comorbidities, and kind of like what you were mentioning, that could be anything from heart disease to diabetes to hypertension to osteoarthritis and bone disease. So it’s really imperative that we do diagnose our patients early and not miss that.

Well, this has been a great bite-sized discussion. Our time is up, but we’re so glad you joined us.

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