Acromegaly

more about Acromegaly

Also known as

Gigantism and hyperpituitarism

Description

  • Acromegaly is the excessive production of growth hormone, which continues to be produced well into adulthood. In adults it is involved in regulatory functions in the body, but since the growth plates are closed, excessive levels cause abnormal growth of hands, feet, and internal organs.
  • Since pituitary tumors are the most common cause of this condition, other areas controlled by the pituitary are often affected (such as Prolactin and thyroid hormones).
  • In children, excess growth hormone causes increased height known as gigantism.

Symptoms

  • Numbness or tingling of skin

Cause

  • Pituitary tumor (usually benign)

How the diagnosis is made

  • Examination:
    1. Large “doughy” hands
    2. Large feet
    3. Large face
    4. Enlarged jaw
    5. Tongue problems
    6. Big forehead
    7. Darkened skin in armpits
    8. Widely spaced teeth
    9. Oily, tough skin
    10. Skin pigmentation changes (i.e., darker or lighter)
    11. Excessive hair growth in females
    12. High Blood Pressure
    13. Goiter (enlarged thyroid)
    14. Kyphosis or loss of disc spaces of the spine
    15. Osteoporosis
    16. Osteoarthritis (e.g., knees)
  • Laboratory findings:
    1. Growth hormone level is high, even when patient receives glucose (sugar) load
    2. Diabetes (elevated blood sugar) occurs in 30%
    3. Elevated IGF-1 factor (Insulin-like growth factor)
    4. Prolactin level (elevated)
    5. Liver function tests (elevated)
    6. Blood Urea nitrogen (elevated)
    7. Phosphorus (elevated)
    8. Free Thyroxine (decreased)
    9. Thyroid stimulating hormone (elevated)
  • Imaging:

– MRI shows pituitary tumor

Treatment

  • Pituitary microsurgery to remove tumor
  • Pituitary radiation if surgery fails
  • Gamma knife radiation treatment (a special type of focused radiation)
  • Medications that may help:
  • Bromocriptine (helps decrease growth hormone in some patients)
  • Octreotide (partially shrinks pituitary tumors)

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