Acromegaly differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
Acromegaly must be differentiated from other diseases that cause acral features like skin thickening and linear bone growth. These diseases such as Marfan syndrome, | Acromegaly must be differentiated from other diseases that cause acral features like [[skin]] thickening and linear [[bone]] growth. These diseases such as [[Marfan syndrome]], [[precocious puberty]], [[prolactinoma]], and [[pachydermoperiostosis]]. | ||
==Differentiating acromegaly from other Diseases== | ==Differentiating acromegaly from other Diseases== | ||
*Acromegaly must be differentiated from other diseases that cause acral features like skin thickening and linear bone growth. These diseases such as Marfan syndrome, precocious puberty, prolactinoma | *Acromegaly must be differentiated from other diseases that cause acral features like [[skin]] thickening and linear bone growth. These diseases such as [[Marfan syndrome]], [[precocious puberty]], [[prolactinoma]], and [[pachydermoperiostosis]].<ref name="pmid28567291">{{cite journal| author=Abdullah NRA, Jason WLC, Nasruddin AB| title=Pachydermoperiostosis: a rare mimicker of acromegaly. | journal=Endocrinol Diabetes Metab Case Rep | year= 2017 | volume= 2017 | issue= | pages= | pmid=28567291 | doi=10.1530/EDM-17-0029 | pmc=5445428 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28567291 }}</ref><ref name="pmid20591885">{{cite journal| author=Loeys BL, Dietz HC, Braverman AC, Callewaert BL, De Backer J, Devereux RB et al.| title=The revised Ghent nosology for the Marfan syndrome. | journal=J Med Genet | year= 2010 | volume= 47 | issue= 7 | pages= 476-85 | pmid=20591885 | doi=10.1136/jmg.2009.072785 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20591885 }}</ref><ref name="pmid15191331">{{cite journal| author=Liu JK, Couldwell WT| title=Contemporary management of prolactinomas. | journal=Neurosurg Focus | year= 2004 | volume= 16 | issue= 4 | pages= E2 | pmid=15191331 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15191331 }}</ref><ref name="pmid16860125">{{cite journal| author=Papadimitriou A, Beri D, Tsialla A, Fretzayas A, Psychou F, Nicolaidou P| title=Early growth acceleration in girls with idiopathic precocious puberty. | journal=J Pediatr | year= 2006 | volume= 149 | issue= 1 | pages= 43-6 | pmid=16860125 | doi=10.1016/j.jpeds.2006.02.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16860125 }}</ref> | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Prolactinoma]] | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Prolactinoma]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* On physical examination, prolactinoma demonstrates visual field defects and diplopia as acromegaly. | * On physical examination, prolactinoma demonstrates [[Visual field defect|visual field defects]] and [[diplopia]] as acromegaly. | ||
* On symptoms, prolactinoma patients complain of a headache as the acromegaly. | * On symptoms, prolactinoma patients complain of a [[headache]] as the acromegaly. | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* On physical examination, prolactinoma demonstrates hydrocephalus that distinguishes it from acromegaly. | * On physical examination, prolactinoma demonstrates [[hydrocephalus]] that distinguishes it from acromegaly. | ||
* On symptoms, patients with prolactinoma may show cerebrospinal fluid rhinorrhea. | * On symptoms, patients with prolactinoma may show [[cerebrospinal fluid]] [[rhinorrhea]]. | ||
* On laboratory tests, prolactinoma has high level of prolactin that distinguishes it from acromegaly. | * On laboratory tests, [[prolactinoma]] has a high level of [[prolactin]] that distinguishes it from acromegaly. | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Marfan syndrome | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Marfan syndrome]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* On physical examination, Marfan syndrome has demonstrated cardiac manifestations as the acromegaly. | * On physical examination, Marfan syndrome has demonstrated [[cardiac]] manifestations as the acromegaly. | ||
* On physical examination, Marfan syndrome demonstrates excess linear bone growth like acromegaly. | * On physical examination, Marfan syndrome demonstrates excess linear [[bone]] growth like acromegaly. | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* On physical examination, Marfan syndrome patients have small jaws that distinguish it from acromegaly. | * On physical examination, Marfan syndrome patients have small [[Jaw|jaws]] that distinguish it from acromegaly. | ||
* Patients with Marfan syndrome have arachnodactyly with positive thumb and wrist signs. | * Patients with Marfan syndrome have arachnodactyly with positive thumb and wrist signs. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Precocious puberty | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Precocious puberty]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* On physical examination, excess linear bone growth is noticed like the acromegaly. | * On physical examination, excess linear bone growth is noticed like the acromegaly. | ||
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* On laboratory diagnosis, precocious puberty has demonstrated high levels of FSH, LH and testosterone that distinguish it from acromegaly. | * On laboratory diagnosis, precocious puberty has demonstrated high levels of FSH, LH and testosterone that distinguish it from acromegaly. | ||
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Pachydermoperiostosis (Primary hypertrophic osteoarthropathy) | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Pachydermoperiostosis]] (Primary hypertrophic osteoarthropathy) | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* On physical examination, pachydermoperiostosis demonstrates thickening of skin and scalp, clubbing and arthritis like acromegaly. | * On physical examination, pachydermoperiostosis demonstrates thickening of skin and scalp, clubbing and arthritis like acromegaly. | ||
Revision as of 15:58, 14 August 2017
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Acromegaly Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]
Overview
Acromegaly must be differentiated from other diseases that cause acral features like skin thickening and linear bone growth. These diseases such as Marfan syndrome, precocious puberty, prolactinoma, and pachydermoperiostosis.
Differentiating acromegaly from other Diseases
- Acromegaly must be differentiated from other diseases that cause acral features like skin thickening and linear bone growth. These diseases such as Marfan syndrome, precocious puberty, prolactinoma, and pachydermoperiostosis.[1][2][3][4]
| Differential Diagnosis | Similar Features | Differentiating Features |
|---|---|---|
| Prolactinoma |
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| Marfan syndrome |
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| Precocious puberty |
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| Pachydermoperiostosis (Primary hypertrophic osteoarthropathy) |
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References
- ↑ Abdullah NRA, Jason WLC, Nasruddin AB (2017). "Pachydermoperiostosis: a rare mimicker of acromegaly". Endocrinol Diabetes Metab Case Rep. 2017. doi:10.1530/EDM-17-0029. PMC 5445428. PMID 28567291.
- ↑ Loeys BL, Dietz HC, Braverman AC, Callewaert BL, De Backer J, Devereux RB; et al. (2010). "The revised Ghent nosology for the Marfan syndrome". J Med Genet. 47 (7): 476–85. doi:10.1136/jmg.2009.072785. PMID 20591885.
- ↑ Liu JK, Couldwell WT (2004). "Contemporary management of prolactinomas". Neurosurg Focus. 16 (4): E2. PMID 15191331.
- ↑ Papadimitriou A, Beri D, Tsialla A, Fretzayas A, Psychou F, Nicolaidou P (2006). "Early growth acceleration in girls with idiopathic precocious puberty". J Pediatr. 149 (1): 43–6. doi:10.1016/j.jpeds.2006.02.005. PMID 16860125.