Acromegaly

What is it?

Acromegaly is triggered by an excess of growth hormone. The most apparent signs of acromegaly arise from the overgrowth of bones in the face, hands and feet causing facial disfigurement, big hands and feet. However, the modifications take place so slowly that they go undetected for a very long time.

Acromegaly establishes after the individual has actually maturated. In children, the same condition causes severe high stature (gigantism). People aged between 30 and 50 years are most commonly affected. About 1,000 people in Australia are approximated to have acromegaly.

In about 95% cases acromegaly and gigantism are secondary to a GH secreting adenoma in the pituitary gland.

Acromegaly - big hands disease

https://www.ncbi.nlm.nih.gov/books/NBK538261/

A non-cancerous (benign) tumor on the pituitary gland is the most common cause. The pituitary gland, situated in the brain, produces a number of hormones consisting of growth hormone. Growth hormone promotes growth in childhood and in an adult, it manages metabolic process, muscle and bone mass.

Excessive amounts of growth hormone stimulate the growth of all body tissues. This effect is moderated by a growth aspect called IGF-I, which is produced in the liver.

Symptoms of Acromegaly

The symptoms and signs of acromegaly can include:

  • joint pains.
  • spaces forming in between the teeth, which may cause a ‘bad bite’.
  • headaches.
  • bigger tongue and lips.
  • growth of skin ‘tags’.
  • snoring or drooling while asleep.
  • barrel chest.
  • thick and oily skin and strong body odor.
  • vision modifications, such as loss of peripheral (side) vision.
  • heavy sweating (hyperhidrosis).
  • husky voice.
  • pins and needles in the hands.
  • swelling of soft tissue in the hands and feet (start signs).
  • bigger heart (cardiomegaly).
  • overgrowth of hair.
  • enlarged bones in the skull, face, jaw, hands and feet.

People often call this pathology as big hands disease, big legs disease, etc.

If you suspect acromegaly, you should contact a physician or directly to an endocrinologist.

Causes of Acromegaly

A pituitary tumor (adenoma) is the commonest cause of acromegaly. The adenoma secretes excessive amounts of growth hormone, which impacts many tissues of the body, including the bones and skin. The hormone imbalance usually causes disturbances in other hormonal systems. For instance, excessive growth hormone can cause diabetes, which happens in up to one quarter of individuals with the condition. Affected women can have menstrual cycle irregularities.

The adenoma slowly increases the size of and may press versus the surrounding tissue, causing headaches. If the nerves to the eyes are compressed, this can cause vision impairment.

Particular tumors in other organs, such as the lungs or pancreas, can very rarely cause acromegaly. These tumors either make growth hormone or make a chemical called growth hormone-releasing hormone (GHRH) that triggers the pituitary gland to make growth hormone.

Progress of the condition depends on tumor size.

The development of acromegaly depends upon the secretion activity and size of the tumor. In general, acromegaly advances faster and more strongly in individuals who establish a pituitary tumor early in adult life. The cause of pituitary tumors is unidentified. Without a known cause, it is difficult to predict or prevent acromegaly.

Complications of Acromegaly

Without medical treatment, acromegaly can cause a variety of complications including:

  • heart disease.
  • premature death.
  • diabetes.
  • high blood pressure (hypertension).
  • carpal tunnel syndrome.
  • that the individual frequently stops breathing or chokes while sleeping (sleep apnoea).
  • arthritis.

Medical Diagnosis of Acromegaly

Acromegaly is difficult to detect in its early stages, because the physical changes happen over several years. Following a suspicion of acromegaly based on history and health examination, blood tests are required for verification of diagnosis.

  • An IGF-I (a growth factor produced in the liver) measurement is the most reputable diagnostic test.
  • A measurement of growth hormone is of restricted value as its concentration varies in blood.
  • Imaging of the pituitary gland by CT or MRI scans is carried out to figure out the size and place of the adenoma.

Treatment for Acromegaly

Treatment reduces the swelling of the soft tissue in the face, hands and feet however can not reverse the impacts on the bones. Treatment is aimed at getting rid of the pituitary tumor, or minimizing its activity. Alternatives may consist of:.

  • Drugs — somatostatin analogues (brand name Sandostatin and Lanreotide) work in inhibiting the growth hormone secretion from the tumor and can likewise lower tumor size. They may be used as the first line of treatment or may be used to manage recurring disease after surgery. A new drug called pegvisomant is a valuable addition — it works by obstructing the action of growth hormone.
  • Surgery — offers the only possibility of cure from total removal of the tumor. Success is dependent on the size, location of the tumor and surgical skill. Surgery is typically performed through the person’s nose.
  • Radiation therapy — is typically provided to manage recurring disease after surgery.

According to MayoClinic, doctors can get rid of most pituitary growths utilizing a technique called transsphenoidal surgery. During this procedure, your surgeon overcomes your nose to eliminate the growth from your pituitary gland. If the tumor triggering your symptoms isn’t found on your pituitary gland, your doctor will suggest another type of surgery to get rid of the growth. Oftentimes — particularly if your tumor is little — removal of the tumor returns your GH levels to normal. If the tumor was putting pressure on the tissues around your pituitary gland, removing the tumor also helps relieve headaches and vision modifications.

The doctor may select several treatments depending upon the scenarios and indicators.

An individual with acromegaly must have routine medical tests to monitor the condition. Tests might include a yearly medical check-up and blood tests to determine growth hormone status.

What Else You Should Know

  • Acromegaly is a condition caused by an excess of growth hormone, which causes the overgrowth of bones in the face, hands and feet.
  • A tumor on the pituitary gland is the most typical reason for acromegaly.

Acromegaly is triggered by an excess of growth hormone. The most apparent signs of acromegaly emerge from the overgrowth of bones in the face, hands and feet causing facial disfigurement, big hands and feet. A pituitary tumor (adenoma) is the commonest cause of acromegaly. In basic, acromegaly progresses quicker and more strongly in individuals who establish a pituitary tumor early in adult life. Without a known cause, it is difficult to predict or prevent acromegaly.

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