Epidemiological, Clinical and Therapeutic Profiles of Acromegaly in Senegal: About 25 Cases

Introduction: Acromegaly is diagnosed on the basis of elevated IGF1 and GH levels. Management is primarily by pituitary surgery. In Senegal, the few studies of acromegaly have been based on descriptions of isolated cases. The aim was to study aspects of acromegaly through a national multicenter registry. Methodology: This was a multicenter, retrospective study conducted from January 1er 2008 to December 31 2022 in the Dakar neurosurgery departments and the endocrinology department of the Abass Ndao hospital. It focused on confirmed cases of acromegaly followed up in our respective departments. Results: 25 cases were included, with a mean age of 42.5 ± 12 years and a sex ratio of 1.5. The main circumstances of discovery were a tumor syndrome (100%), craniofacial dysmorphia (36%), diabetes mellitus (44%), arterial hypertension (40%), decreased visual acuity (68%), photophobia (68%). Gigantism was found in 52%, and the main signs of dysmorphic syndrome were prognathism (100%), protruding cheekbones (100%), thickened lips (100%), macroglossia (100%), enlarged extremities (100%), dysphonia (92%), pneumatization of the sinuses (92%), marked wrinkles (92%). Mean plasma IGF-1 level was 610.7 ± 2 ng/ml and GH 61.3 ng/ml. Hyperprolactinemia > 100 ng/ml was found in 36%. Macroadenomas were found in 80% of cases, isolated acromegaly in 75% and mixed secretion in 25%. The proportion of patients who had undergone pituitary surgery was 96%, including 30% with postoperative transient diabetes insipidus. There was one case of post-operative death, related to pulmonary embolism. Conclusion: In our practice, the diagnosis of acromegaly remains late in view of the symptoms and frequency of macroadenomas. In the absence of somatostatin analogues, surgery was the treatment of choice, despite some complications.