ObjectivePseudoacromegaly encompasses conditions with features of acromegaly/gigantism, but no growth hormone (GH) or insulin‐like growth factor‐1 (IGF‐1) excess. We aimed to review published pseudoacromegaly cases evaluated due to clinical suspicion of acromegaly.Design/PatientsPubMed/Medline search was conducted to identify reported pseudoacromegaly cases, which were systematically reviewed to ensure they met eligibility criteria: (1) presentation suggestive of acromegaly; (2) acromegaly excluded based on normal GH, IGF‐1 and/or GH suppression on oral glucose tolerance test (OGTT‐GH); (3) diagnosis of the pseudoacromegaly condition was established. Data were retrieved from each case and analysed collectively.ResultsOf 76 cases, 47 were males, mean ages at presentation and at first acromegaloid symptoms were 28 ± 16 and 17 ± 10 years, respectively. Most common conditions were pachydermoperiostosis (47%) and insulin‐mediated pseudoacromegaly (IMP) (24%). Acromegaloid facies (75%) and acral enlargement (80%) were the most common features. Measurement of random GH was reported in 65%, IGF‐1 in 79%, OGTT‐GH in 51%. GH excess was more frequently excluded based on two tests (53%). Magnetic resonance imaging (MRI) was performed in 30 patients, with pituitary adenoma or hyperplasia being reported in eight and three patients, respectively. Investigations differed between cases managed by endocrine and non‐endocrine specialists, the former requesting more often IGF‐1, OGTT‐GH and pituitary MRI.ConclusionsPseudoacromegaly is a challenging entity that may be encountered by endocrinologists. Pachydermoperiostosis and IMP are the conditions most often mimicking acromegaly. Adequate assessment of GH/IGF‐1 is crucial to exclude acromegaly, which may be better performed by endocrinologists. Pituitary incidentalomas are common and require careful judgement to prevent unnecessary pituitary surgery.

中文翻译：

---

假性肢端肥大症——内分泌诊所中的一个具有挑战性的实体：系统评价

目的假性肢端肥大症包括具有肢端肥大症/巨人症特征，但没有生长激素 (GH) 或胰岛素样生长因子-1 (IGF-1) 过量的病症。我们的目的是回顾已发表的因临床怀疑肢端肥大症而评估的假性肢端肥大症病例。Design/PatientsPubMed/Medline 搜索旨在识别报告的假性肢端肥大症病例，并系统地审查这些病例以确保它们符合资格标准：(1) 表现提示肢端肥大症； (2) 基于 GH、IGF-1 正常和/或口服葡萄糖耐量试验 (OGTT-GH) GH 抑制排除肢端肥大症； (3)假性肢端肥大症的诊断成立。从每个病例中检索数据并进行集体分析。结果 76 例中，47 例为男性，出现肢端肥大症症状时的平均年龄和首次出现肢端肥大症症状的平均年龄分别为 28 ± 16 岁和 17 ± 10 岁。最常见的病症是厚皮骨膜增生症（47%）和胰岛素介导的假性肢端肥大症（IMP）（24%）。肢端肥大样面容（75%）和肢端增大（80%）是最常见的特征。据报道，随机 GH 测量占 65%，IGF-1 占 79%，OGTT-GH 占 51%。根据两项测试 (53%)，更频繁地排除 GH 过量。对 30 名患者进行了磁共振成像 (MRI)，其中 8 名患者和 3 名患者分别报告有垂体腺瘤或增生。内分泌专家和非内分泌专家管理的病例之间的调查有所不同，前者需要更频繁地进行 IGF-1、OGTT-GH 和垂体 MRI 检查。 结论 假性肢端肥大症是内分泌科医生可能遇到的具有挑战性的疾病。骨膜肥厚症和 IMP 是最常模仿肢端肥大症的病症。充分评估 GH/IGF-1 对于排除肢端肥大症至关重要，内分泌科医生可能会更好地进行评估。垂体偶发瘤很常见，需要仔细判断，以防止不必要的垂体手术。