Acromegaly

image courtesy of (http://www.faqs.org/health/images/uchr_01_img0062.jpg)

legs showing symptoms of acromegaly

What is it?

A rare disorder that usually occurs as a result of a tumour on the pituitary gland which produces too much Growth Hormone (GH). The tumour responsible is benign but it can grow to an extremely large size. in even rarer cases acromegaly can be caused by a tumour elsewhere in the body.

 

Hows does having Acromegaly affect the body?

In children

this can cause Gigantism which is when children grow to an exceptional height.

In adults

As they have stopped growing Acromegaly can not affect the height but there are other distinct symptoms.

 

Symptoms of Acromegaly

The time which symptoms take to appear, varies significantly and relates to the growth of the tumour. Generally, symptoms occur gradually and they are not only a result of the increased hormone being produced but also the physical presence of the tumour itself.  

GH stimulates other factors which promote bone growth therefore there is often an enlargement of the hands and feet. The overgrowth of cartilage can lead to alterations in the shape of the face, mostly commonly the jaw becomes more prominent.

Over growth of tissue in the hands can cause nerves to be trapped and results in pain in the hands (carpel tunnel syndrome).

 The physical growth of the tumour itself can cause headaches as it expands within the brain cavity. This can also impact on vision if the tumour presses on the optic nerve. The growth of the tumour can also further damage the pituitary to the point where secretion of other hormones is effected thus increasing the chance of other medical problems.

 

How is Acromegaly diagnosed?

The most common intial test is the glucose tolerance test. This is testing for the level of GH in the blood. In a normal state growth hormone production fluctuates throughout the day. This is normally supressed after a high sugar food or drink is consumed. In acromegaly suffers, the GH level is too high for it to be affected by the ingestion of a sugary food. Once the sugar has been eaten a blood test is taken at intervals for a total of 2 hours. In Acromegaly cases GH levels are extremly high. 

After this initial test, if results indicate Acromegaly then a MRI scan may be done to see whether a tumour is present.                                                                                                                                                                                                                                                                                                                                                                                                                                                         

 

 Treatment

The most common way to treat this condition is to remove the tumour via neurosurgery. This is normally extremely sucessful and often facial features will return to their pre-acromegaly shape. If surgery is not possible then a combination of raditation and drug theraphy is used.