Aktuelle Rheumatologie 2018; 43(03): 235-239
DOI: 10.1055/s-0043-122675
Übersichtsarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Gelenkbeteiligung bei Akromegalie

Rheumatic Manifestations in Acromegaly
Susann Patschan
1   Clinic of Nephrology and Rheumatology, University Hospital of Göttingen, Göttingen
,
Daniel Patschan
2   Medizinische Hochschule Brandenburg Theodor Fontane, Klinik für Kardiologie, Pulmologie, Angiologie und Nephrologie, Brandenburg
,
Dirk Raddatz
3   Clinic of Gastroenterology, University Hospital of Göttingen, Göttingen
,
Katja Gollisch
3   Clinic of Gastroenterology, University Hospital of Göttingen, Göttingen
› Author Affiliations
Further Information

Publication History

Publication Date:
05 February 2018 (online)

Zusammenfassung

Die Akromegalie ist eine seltene Erkrankung, welche in den meisten Fällen aus einer hypophysären Überproduktion von Wachstumshormon (GH – Growth Hormone) resultiert. Der in der Folge anhaltende IGF-1(Insulin like Growth Factor-1)-Exzess bewirkt zahlreiche morphologische und metabolische Veränderungen des Organismus inklusive Organomegalie, arterieller Hypertonie und Diabetes mellitus. Insbesondere die kardiovaskuläre Morbidität nimmt zu, diese ist auch hauptverantwortlich für vermehrte Sterblichkeit der Betroffenen. Wiewohl nicht prognoseentscheidend, manifestiert sich die Erkrankung gleichfalls am Bewegungsapparat. Drei Komplikationen sind relevant: eine Arthropathie größerer Gelenke, lumbale Wirbelsäulenveränderungen sowie das Karpaltunnelsyndrom. Die Behandlung dieser Komplikationen unterscheidet sich nicht von der Therapie anderer Krankheitsmanifestationen: entscheidend ist die Beseitigung des GH-/IGF-1-Exzesses. Je früher die Diagnose gestellt und die Behandlung eingeleitet wird, desto besser ist die Prognose, sind doch ossäre/artikuläre Veränderungen in vielen Fällen irreversibel.

Abstract

Acromegaly is a rare disease, which mostly results from pituitary overproduction of growth hormone (GH) followed by uncontrolled release of insulin-like growth factor-1 (IGF-1). The latter induces organ damage and metabolic disturbances including organomegaly, arterial hypertension and diabetes mellitus. Cardiovascular diseases are the most common cause of death in acromegaly patients. Individuals also frequently suffer from rheumatic disorders including large-joint disease, spinal affection and carpal tunnel syndrome. The most important therapeutic measure is to normalise GH/IGF-1 levels. Nevertheless, some rheumatic manifestations may not necessarily resolve since joint and spine affection are often irreversible in nature.

 
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