ACROMEGALY

What is Acromegaly?
Acromegaly is a syndrome that happens when the pituitary gland produces excess growth hormone (hGH) after epiphyseal plate 1closure at puberty. Acromegaly is diagnosed mostly in middle-aged adults, but symptoms can appear at any age. If it s not treated, it can result in serious illness and premature death.

What are the signs and symptoms?

Many common signs are abnormal growth of hands and feet, which is normally an early feature. Then gradually bone changes alter the face structure. Other symptoms are: y y y y y y y y y y y y y
1

Increase in ring size or tightness of rings Foot Swelling Increased sweating Coarsening or thickening of facial features Increased prominence of jaw and/or forehead Thickened skin, especially on palms of hands or soles of feet Oily skin or acne Swelling of tongue Thickening or swelling of the neck Arthritis sleep apnea Pain, numbness, tingling, or weakness in hands and wrists New overbite, underbite, or spreading out of teeth

Epiphyseal plate- is a hyaline cartilage plate in the metaphysic at each end of a long bone.

What causes Acromegaly?

Acromegaly is caused by prolonged overproduction of GH by the pituitary gland. And your pituitary produces the hormones that control, growth, development, reproduction, metabolism. If the pituitary makes GH independent over the other hormones the body produces, the level of IGF-I2 continues to rise which makes the bone and organs over grow. Then high levels of IGF-I change the glucose and lipid metabolism which can lead to diabetes, high blood pressure and heart disease. Pituitary Tumors More than 95 percent of people with acromegaly develop a benign tumor of the pituitary called an adenoma. If the tumor affects part of the pituitary that controls the thyroid then the thyroid hormones may decrease. If not enough thyroid hormone is produced it can cause weight gain, fatigue, hair and skin changes. And if the tumor affects the part of the pituitary that controls the adrenal gland, then cortisol may decrease which can cause weight loss, dizziness, fatigue, low blood pressure and nausea.

Nonpituitary Tumors

Rarely acromegaly is caused by tumors of the pancreas, lungs, and other parts of the brain. When these tumors are surgically removed , the GH levels fall and the symptoms improve.

How common is acromegaly?

Scientists estimate that 3 out of 4 of every million people a year can develop acromegaly. Because the diagnosis is often missed these numbers probably underestimate the frequency of the disease.

How is acromegaly diagnosed?

Blood Tests Imaging Lab Tests

IGF-I- Insulin/Insulin-Like Growth Factor I (protein)

How is acromegaly treated?

Currently there are 3 types of treatment: Surgery, Medical Therapy and radiation therapy of the pituitary. The goals of the treatment are to reduce excess hormone production to normal levels, relieve the pressure of the growing tumor, preserve normal pituitary function and overall improve the symptoms of acromegaly. Types of medication are: y y y y
Octreotide which can be taken only as shots once monthly. Somavert which is a growth hormone receptor blocker Dopamine works by stopping the secretion of the growth hormone Parlodel is a convienent, inexpensive oral form