Median Neuropathy (Carpal-Tunnel Syndrome) in Acromegaly

Of 100 acromegalic patients, 35 had carpal-tunnel syndrome. All but 1 of the 35 had active acromegaly, as judged by clinical and laboratory methods. Of the 100 patients, 63 had active acromegaly, 17 had inactive acromegaly, and 20 had acromegaly that was of indeterminate activity. Statistical analysis showed that carpal-tunnel syndrome in acromegaly denotes ongoing pituitary overactivity (P < 0.001). In every patient in whom pituitary treatment was successful, whether by irradiation (three of nine) or surgery (five of six), the syndrome was abolished completely. Although failure to correct hypersomatotropism usually led to continuation of this syndrome, the latter sometimes cleared despite residual pituitary overactivity. Therefore, whereas carpal-tunnel syndrome in acromegaly is a useful indicator of active disease, its disappearance does not necessarily indicate that growth hormone output has returned to normal.