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Acromegaly

Overview:

Acromegaly is a rare hormonal disorder characterized by an over-production of Growth Hormone (GH) by the pituitary gland. The pituitary gland is an endocrine gland located at the base of the brain involved in the synthesis of several hormones including GH.

The first symptom of this disorder is the abnormal growth of the hands and feet and more generally an increase of the bones size. Even though Acromegaly can develop at any age, it usually affects middle-aged women and men.

Because Acromegaly is uncommon and physical changes occur very slowly, the condition sometimes takes from 3 to 6 years to be diagnosed and can lead to severe complications such as severe damage to the joints and problems affecting the cardiovascular and respiratory systems.  

In Europe, Acromegaly affects approximately 1.2 in 10,000 people.

The most well accepted treatment goal is to target the source of the Growth Hormone over production.  Typical treatments include surgery and/or medical treatment.  With proper medical treatment, the progression of the disease can be halted or symptoms reduced

Diagnosis: 

Physician most often diagnose acromegaly by ordering two blood tests that help determine if the body is making too much GH. First one is IGF test. First, by measuring the level of IGF-I in the blood Levels, a reliable way to track GH in the body. A high IGF-I level suggests acromegaly. Secondly, oral glucose tolerance test will confirm the diagnosis, as growth hormone levels and blood glucose levels are connected.

If the blood tests confirm that the body is making too much GH, imaging tests will be conduct to locate and measure the tumor that may be causing the problem. The preferred test for viewing a pituitary tumor is the magnetic resonance imaging (MRI).

Symptoms: 

Patients with Acromegaly may develop the following signs and symptoms: 

  • hands and feet become larger and swollen—you may notice a change in ring or shoe size, especially shoe width
  • lips, nose, and tongue become larger
  • Enlarged facial features, causing the bow and lower jaw to protrude, nasal bone enlargement and teeth space out
  • Oily, thickened and hairier skin
  • Excessive sweating
  • Deepening of the voice
  • Headaches
  • Problems with the vision
  • Heavy snoring
  • Daytime sleepiness

Causes:

Acromegaly is characterised by a hypersecretion of Growth Hormone (GH) by the pituitary gland. The pituitary gland is an endocrine gland located at the base of the brain, which produces different hormones, including Growth Hormone.

Growth Hormone stimulates growth, cell reproduction, cell regeneration and the production of insulin-like growth factor-1 (IGF-1) once released in the bloodstream. If too much GH is secreted, too much IGF-1 can lead to acromegaly and gigantism.

In 95% of cases, Acromegaly is caused by a non-cancerous tumor of the pituitary gland called a pituitary adenoma.