سندرم كارپال تانل در بيماران مبتلا به آكرومگالي

Carpal Tunnel Syndrome in Patients with Acromegaly

Background and Objectives: Acromegaly is an important risk factor for carpal tunnel syndrome (CTS), observed clinically in 50% of the patients with acromegaly; however with electro diagnostic tests, this rate increases to 80%. Because numerous diagnostic methods are available for CTS, determining a suitable screening test, seems necessary. Materials and Methods: We analyzed 15 patients with criteria for acromegaly and mean age of 39.9 years old, in whom mean duration of 4.8 years were past from successful treatment, for determining prevalence of CTS with various electrodiagnostic tests. Results: Clinically symptomatic CTS was noted in 30% of patients. However, with electro diagnostic tests this rate increased to 70%. Of various electro diagnostic methods, median and radial nerves sensory action potential was more sensitive for CTS, and with this technique more than 80% of patients with acromegaly were included in CTS group. Conclusion: Median and radial nerves sensory action potential comparison, is recommended as a screening test for CTS. Despite successful management of patients with acromegaly, the reason for high rate of occurance of CTS in these patients may be related to irriversible carpal tunnel stenosis due to bony hypertrophy and/or hyperplasia of tendons. Fortunately, CTS is often asymptomatic or mildly symptomatic; thus, the majority of patients are treated conservatively, and only in rare cases surgery is required.