Acromegaly: Overproduction of growth hormone.
Acromegaly is a rare and chronic endocrine disorder characterized by the overproduction of growth hormone (GH) by the pituitary gland. This excess GH leads to the abnormal growth of tissues, bones, and organs, particularly in the hands, feet, and face. Acromegaly is a slowly progressing condition, and if left untreated, it can result in significant health complications. In this article, we will explore what acromegaly is, its causes, symptoms, diagnosis, and treatment options.
What is Acromegaly?
Acromegaly is a condition that results from the excessive secretion of growth hormone (GH) by the pituitary gland. GH plays a crucial role in regulating growth during childhood and adolescence. However, in adulthood, excessive GH production can lead to the growth of tissues and organs, causing characteristic changes in the body.
Causes of Acromegaly
Acromegaly is primarily caused by the presence of a noncancerous tumor in the pituitary gland, known as a pituitary adenoma. This adenoma stimulates the pituitary gland to produce and release excessive amounts of GH. While most cases of acromegaly are caused by pituitary adenomas, other rare causes can include tumors outside the pituitary gland that also produce GH.
Symptoms of Acromegaly
The symptoms of acromegaly can vary widely among individuals and typically develop slowly over time. Common symptoms and physical changes associated with acromegaly may include:
Growth of Facial Features: Enlargement of the nose, lips, and ears.
Enlarged Hands and Feet: Increased shoe and ring sizes due to the growth of bones and tissues.
Protruding Jaw (Prognathism): The lower jaw may extend forward.
Thickened Skin: Skin thickening, particularly on the palms and soles.
Joint Pain: Due to the growth of tissues around joints.
Headaches: Persistent or severe headaches.
Vision Problems: Tumors may press on the optic nerves, causing vision changes.
Fatigue: Generalized weakness and fatigue.
Sweating and Oily Skin: Increased perspiration and skin oiliness.
Sleep Apnea: Breathing difficulties during sleep.
Cardiovascular Issues: High blood pressure and an increased risk of heart disease.
Diagnosis of Acromegaly
Diagnosing acromegaly involves a combination of medical history, physical examination, and laboratory tests. Common diagnostic tests and procedures may include:
Growth Hormone Testing: Blood tests to measure GH levels, including GH suppression tests.
Insulin-Like Growth Factor-1 (IGF-1) Testing: A blood test to measure IGF-1 levels, which are elevated in acromegaly.
Imaging Studies: MRI or CT scans to identify pituitary tumors or other abnormalities.
Visual Field Testing: To assess vision changes caused by pressure on the optic nerves.
Treatment of Acromegaly
The primary goal of acromegaly treatment is to reduce GH levels and alleviate symptoms. Common treatment approaches include:
Surgery: Surgical removal of the pituitary adenoma (transsphenoidal surgery) is often the first-line treatment.
Medications: Medications like somatostatin analogs (e.g., octreotide or lanreotide) may be used to lower GH levels.
Radiation Therapy: In cases where surgery and medication are not effective, radiation therapy may be considered.