ACROSCORE: A new and simple tool for the diagnosis of acromegaly, a rare and underdiagnosed disease

Nunzia Prencipe, Irene Floriani, Federica Guaraldi, Stellina V. Di Giacomo, Salvatore Cannavo, Giorgio Arnaldi, Alessandro Berton, Valter Torri, Maurizio Spinello, Emanuela Arvat, Ezio Ghigo, Silvia Grottoli

Research output: Contribution to journalArticlepeer-review

Abstract

Objective Acromegaly, a disease caused by GH/IGF-I hypersecretion, is associated with a high mortality rate; early recognition is therefore necessary to ensure successful treatment and to avoid comorbidities. We have created a symptom/sign scoring tool (ACROSCORE) for physicians to use to identify acromegaly. Design To compare cases of acromegaly diagnosed between 1990 and 2014 against a control group affected by non-GH-secreting pituitary tumours to identify symptoms and signs that are most discriminative for acromegaly. Patients Confirmed acromegaly patients and patients affected by non-GH-secreting pituitary tumours. Measurements In all patients, signs, symptoms and comorbidities were recorded from medical records and collected using a specifically designed questionnaire. Results A total of 194 acromegaly patients [115 women; mean (SD) age 47·2 (14·2) years] and 243 patients affected by non-GH-secreting pituitary tumours [131 women; mean (SD) age 45·8 (15·8) years] were included. A strong association was observed for type 2/secondary diabetes [odds ratio (OR) 3·7], hyperhidrosis (OR 6·1), thyroid hyperplasia (OR 13·9), colorectal polyps (OR 10·4), spaced teeth (OR 25·4) and carpal tunnel syndrome (OR 4·3). Based on this information, a multivariable logistic model was built and a 14-point scoring system developed. A score of 0 excludes the risk of acromegaly [positive predictive value (PV+) = 0·6%]; scores 1-5 comprise a grey area; scores >5 indicate that a diagnosis of acromegaly cannot be excluded (PV+ = 46·1%). Conclusions Once validated in independent studies, ACROSCORE may represent a new tool for the clinical screening of acromegaly that can be used by general practitioners and nonendocrinology specialists.

Original languageEnglish
Pages (from-to)380-385
Number of pages6
JournalClinical Endocrinology
Volume84
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

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