Treatment and Diagnosis for Acromegaly and Gigantism - Diseases Treatment - Symptoms, Causes and Cure for Diseases on A to Z

What do Doctors call these Conditions?

Hyperpituitarism

What are these Conditions?

Acromegaly and gigantism are chronic, progressive diseases marked by hormonal dysfunction and startling skeletal overgrowth. Acromegaly causes bones to thicken and grow transversely. Gigantism causes proportional overgrowth of all body tissues. These disorders usually reduce life expectancy unless treated in a timely fashion. The earliest signs of acromegaly are swelling and enlargement of the arms, legs, and face. This rare disorder occurs in men and women equally, usually between ages 30 and 50. Gigantism causes remarkable height increases of as much as 6 inches (15 centimeters) a year. Infants and children may grow to three times the normal height for their age; adults may ultimately reach a height of more than 6 feet 8 inches (2 meters).

What Causes them?

Typically, oversecretion of human growth hormone produces changes throughout the body, resulting in acromegaly or, when overA­secretion occurs before puberty, gigantism. Tumors of the anterior pituitary gland may cause this oversecretion, but the causes of the tumors themselves remain unclear. Occasionally, levels of human growth hormone are elevated in more than one family member, suggesting the possibility of a genetic cause.

What are their Symptoms?

Acromegaly develops slowly and typically produces profuse sweating, oily skin, hypermetabolism, and excessive hair growth. Severe headache, central nervous system impairment, loss of sharp vision, and blindness may also result. Oversecretion of human growth hormone produces cartilaginous and connective tissue overgrowth, resulting in a characteristic hulking appearance, with an enlarged ridge over the eye and thickened ears and nose. The jaw may project so much that chewing becomes difficult. Enlargement of the larynx and paranasal sinuses and thickening of the tongue cause the voice to sound deep and hollow. Fingertips display an arrowhead appearance on X-rays, and the fingers are thickened. Irritability, hostility, and various psychological disturbances may occur. Prolonged effects of human growth hormone oversecretion include bowlegs, barrel chest, arthritis, osteoporosis, kyphosis, high blood pressure, and hardening of the arteries. Both gigantism and acromegaly may also cause symptoms similar to those of diabetes. Gigantism develops abruptly, producing some of the same skeletal abnormalities seen in acromegaly. As the disease progresses, the pituitary tumor enlarges and invades normal tissue, thereby causing the organ involved to stop functioning.

How are they Diagnosed?

The doctor will observe a person with acromegaly or gigantism for characteristic features. He or she will order blood tests to measure levels of human growth hormone, which are usually elevated. However, results of this test may be misleading. A lab test called the glucose suppression test may be ordered to obtain more reliable information. Glucose normally suppresses the secretion of growth hormone. If an infusion of glucose does not suppress the hormone level, it may indicate acromegaly or gigantism. In addition, skull X-rays, computed tomography scan (commonly called a CAT scan), arteriography, and magnetic resonance imaging (commonly called MRI) determine the presence and extent of the pituitary lesion. Bone X-rays showing a thickening of the cranium and of the long bones, as well as osteoarthritis in the spine, support this diagnosis.

How are they Treated?

Treatment aims to limit human growth hormone secretion by pituitary radiation therapy or by surgery to remove the underlying tumor. In acromegaly, surgery is mandatory when a tumor causes blindness or other severe neurologic disturbances. Postoperative therapy often requires replacement of thyroid hormones, cortisone, and gonadal hormones. Additional treatment may include administration of Parlodel and Sandostatin, which inhibit human growth hormone synthesis.