Acromegaly in Ibadan--a report of six cases

Six patients with acromegaly were seen over a six year period at the University College Hospital, Ibadan, Nigeria. There were 5 males and 1 female giving a sex ratio which differed from the equal sex prevalence observed in larger caucasian series. The diagnosis was made strictly on clinical grounds with corroborative evidence from x-ray of the skull and limbs. An unusual and unexpected finding was the observation of a hernia or a history of herniorrhaphy in 4 out of the 5 male acromegalics. It was not certain whether the association was real or what the explanation might be. Transfrontal surgery was the only definitive form of treatment that could be offered to the patients because of lack of facilities for transphenoidal adenomectomy or pituitary irradiation. The operation was refused by 4 of the 5 patients to whom surgery was recommended because of cultural fears regarding operations on the brain. Bromocryptine was prescribed as an alternative therapy but its scarcity and prohibitive cost precluded any serious compliance. There is a need to highlight the problems of the silent sufferer of endocrine disorders in developing countries.