BACKGROUND CHANGES OF THE DIGESTIVE SYSTEM MUCOSA IN PATIENTS WITH ACROMEGALY

A A Titaeva,S G Tereshchenko,I A Ilovaiskaya,A V Dreval’,E M Lukina

doi:10.18786/2072-0505-2014-31-29-33

Abstract

Background: Gastrointestinal tract lesions due to the growth hormone impact on mucosa of both the stomach and colon contribute to the complications of acromegaly. In this case, there is a deficiency of the objective assessment data concerning the gastrointestinal tract condition in the acromegaly patients. Aim: To reveal the character of changes in the mucosa of both stomach and colon in the acromegaly patients. Materials and methods: The study is based on the results of analysis of 107 in-patients (32 men and 75 women) with suspected acromegaly who were observed during the period of 2006 to 2012 in the MONIKI Department of Therapeutic Endocrinology. Diagnosis of acromegaly was confirmed. Distribution of patients by gender showed that women suffer from acromegaly in the majority of cases. The ratio men/women equal to 1:2.2 correlates with the literature data. All acromegaly patients underwent the fibroesophago-gastroduodenoscopy, morphological investigation of the stomach mucosa, cytological analysis in search for Helicobacter pylori as well as fibrocolonoscopy plus biopsy in case of the pathological neoplasm identification. Results: Comparative study of changes in the gastrointestinal tract mucosa demonstrated that endoscopic investigation more often showed pathological changes in the upper areas of the digestion tract. It may be explained by the Helicobacter pylori contamination or a side effect of somatostatin analogues in the given group of patients which impairs the stomach epithelium vital activity and enables development of neoplasms in the acromegaly patients. Analysis of the morphofunctional alterations of the stomach-and-colon mucosa in the acromegaly patients revealed concomitant diseases in these patients which were as follows: foveolar hyperplasia of the tegumental-foveolar epithelium, hyperplastic polyps, and tubular adenomas which are an indication for obligatory morphologic investigation of the stomach-and-colon mucosa in this group of patients. Our study proved a high degree of the stomach mucosa contamination with Helicobacter pylori in the acromegaly patients: in 81% of our patients. Conclusion: Our results showed that endoscopy with obligatory targeted biopsy and a search for Helicobacter pylori are extremely necessary for this group of patients. The results obtained are indicative of the necessity of annual gastroenterological examination of patients suffering from acromegaly.

Highlights

CHANGES OF THE DIGESTIVE SYSTEM MUCOSA IN PATIENTS WITH ACROMEGALYTitaeva A.A., Tereshchenko S.G., Lukina E.M., Dreval’ A.V., Ilovaiskaya I.A.Moscow Regional Research and Clinical Institute (MONIKI); 61/2 Shchepkina ul., 129110 Moscow, Russian Federation
Materials and methods: The study is based on the results of analysis of 107 in-patients (32 men and 75 women) with suspected acromegaly who were observed during the period of 2006 to 2012 in the MONIKI Department of Therapeutic Endocrinology
It may be explained by the Helicobacter pylori contamination or a side effect of somatostatin analogues in the given group of patients which impairs the stomach epithelium vital activity and enables development of neoplasms in the acromegaly patients

Summary

ОРИГИНАЛЬНЫЕ СТАТЬИ

Титаева А.А., Терещенко С.Г., Лукина Е.М., Древаль А.В., Иловайская И.А. ГБУЗ МО «Московский областной научно-исследовательский клинический институт им. Цель – выявить характер изменений слизистой оболочки желудка и толстой кишки у больных акромегалией. Всем больным акромегалией были выполнены фиброэзофагогастродуоденоскопия, морфологическое исследование слизистой оболочки желудка, цитологическое исследование на Helicobacter pylori и фиброколоноскопия с биопсией в случае обнаружения патологического образования. Сравнительное изучение изменений слизистой оболочки органов пищеварения показало, что при эндоскопических исследованиях патология чаще встречается в верхних отделах пищеварительного тракта. Это может объясняться инфицированностью Helicobacter pylori и побочным эффектом аналогов соматостатина у данной группы пациентов, что усугубляет жизнедеятельность желудочного эпителия и создает предпосылки для возникновения новообразований у больных акромегалией. Наше исследование установило высокую степень обсемененности слизистой оболочки желудка Helicobacter pylori у пациентов с акромегалией – 81%. Результаты исследования показали, что выполнение эндоскопических исследований с обязательной прицельной биопсией и установление обсемененности Helicobacter pylori являются обязательными. Ключевые слова: акромегалия, поражение желудочно-кишечного тракта, обсемененность Helicobacter pylori

Background

Findings

Распределение больных акромегалией по возрасту