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Medline ® Abstract for Reference 26

of 'Rheumatic and bone disorders associated with acromegaly'

Ultrasound of peripheral nerves in acromegaly: changes at 1-year follow-up.
Resmini E, Tagliafico A, Nizzo R, Bianchi F, Minuto F, Derchi L, Martinoli C, Ferone D
Clin Endocrinol (Oxf). 2009;71(2):220. Epub 2008 Nov 3.
CONTEXT: We have previously demonstrated peripheral nerve enlargement in acromegaly.
OBJECTIVE: The aim of this study was to use ultrasound (US) to assess any changes in the peripheral nerves of patients with acromegaly 1 year after the first evaluation.
PATIENTS: We prospectively examined the median and ulnar nerve cross-sectional area (CSA) in 34 non-diabetic, patients with acromegaly (18 females and 16 males; 18-79 years) and 34 age-, sex-, BMI-matched controls, using a 17-5 MHz US probe.
INTERVENTION: The median nerve was examined at the mid-forearm (MN-f) and at the carpal tunnel (MN-Ct) levels; the ulnar nerve at mid-forearm (UN-f) and at distal arm (UN-a). Patients were grouped according to the clinical control of the disease: 'improved'; 'always controlled'; 'always uncontrolled'; and 'worsened'.
RESULTS: The median nerve at mid-forearm (MN-f), the ulnar nerve at mid-forearm (UN-f) and at distal arm (UN-a) were significantly reduced after 1-year follow-up in all patients (P<0.001, P<0.008, P<0.012, respectively). In the 'improved' group, there was a significant reduction of median nerve CSA examined at mid-forearm (MN-f) (P = 0.02), and distal arm ulnar nerve CSA (UN-a) (P = 0.002). In the other groups no statistically significant differences in ultrasound parameters were recorded. However, UN-a, UN-f, MN-f, MN-ct were still significantly higher in all groups compared with controls (P<0.001).
CONCLUSION: These data demonstrate that median and ulnar nerves CSA are reduced after 1 year follow-up, in line with the reduction of GH/IGF-I levels. However, as the control of the disease incompletely reverts nerve enlargement, this phenomenon could be only partially reversible.
Department of Endocrinology and Medical Sciences (DiSEM), Center of Excellence for Biomedical Research, University of Genoa, Genoa, Italy.