Acromegaly: Causes, Symptoms, Diagnosis, Treatment, Complications
What Is Acromegaly?
Acromegaly is defined as a hormonal disorder caused as a result of overproduction of growth hormones in the pituitary gland in the adolescent years of an individual as a result of which the size of the bones specifically of the hands, feet, and face significantly increase. This disease usually affects people in the middle age group. When this disease affects children, it can cause a medical condition called as gigantism in which children tend to have significantly increased bone growth and abnormally increased height. Since Acromegaly is quite a rare disease and the changes in body are observed very slowly over time hence it is not recognized immediately and may take some time even years to correctly diagnose Acromegaly. If Acromegaly is left untreated for long, it can cause serious medical conditions and even can become life threatening, although there are treatments available which can treat the disease and reduce the symptoms significantly.
What Are The Causes Of Acromegaly?
As stated, in Acromegaly the pituitary gland starts producing more growth hormones than is required. The pituitary gland is situated at the base of the brainstem behind the bridge of the nose. The function of this gland is to produce the growth hormone which plays an important role in physical growth of an individual. When the growth hormone is secreted into the blood it results in production of another hormone called insulin-like growth factor or the IGF-I which is the hormone which causes growth of bones in the body. When there is excessive production of growth hormone, it causes excessive production of IGF-I resulting in abnormal growth of bones and tissues in the body causing gigantism. Some of the causes which results in overproduction of growth hormone are listed below:
Pituitary Tumor: This is the foremost causes of increased production of growth hormones. Pituitary tumors are benign tumors in the pituitary gland. This tumor secretes large amounts of growth hormone resulting in Acromegaly.
What Are The Symptoms Of Acromegaly?
The primary symptom of Acromegaly is significant enlargement of hands and feet. Acromegaly may also result in changes in the shape of face with a protruding jaw and brow, enlargement of nose, thick lips.
Some Of The Other Symptoms Of Acromegaly Are:
- Enlargement of hands and feet
- Coarse facial features
- Thick skin
- Increased sweating
- Presence of skin tags
- Muscle weakness
- Excessive snoring
- Vision abnormalities
- Frequent headaches
- Enlarged tongue
- Restricted joint mobility
How Is Acromegaly Diagnosed?
Some Of The Measures To Diagnose Acromegaly Are:
- Measurement of Growth Hormone and Insulin-like Growth Hormone: For this, the treating physician will take a fasting blood draw to measure the GH and IGF-I levels. In Acromegaly, these levels will be elevated.
- Growth Hormone Suppression Test: This test diagnoses Acromegaly definitively. In this test, the levels of GH are measured after consuming glucose which has a tendency to suppress GH levels and if an individual has Acromegaly then the levels of GH will stay elevated.
- Imaging: If a benign tumor is suspected to be the cause of increased GH, then the physician may recommend MRI or CT scans to point out the exact location of the tumor and remove it.
What Are Treatments For Acromegaly?
The main aim for treatment for Acromegaly is decreasing the levels of growth hormone.
Some Of The Treatment Measures Are:
Surgery: A surgical procedure may be done in cases of benign tumors causing increased production of growth hormones. This surgical procedure is called Transsphenoidal Surgery. In this surgery, the surgeon extracts the pituitary tumor through the nose. Once the offending tumor is removed, then the production of the growth hormone more or less normalizes and there is significant relief of the signs and symptoms of Acromegaly. In cases when the tumor is unable to be removed in its entirety then the growth hormone levels may remain elevated requiring further treatments in the form of radiation therapy.
Apart from the above mentioned surgical procedure, certain medications are also useful in treatment of Acromegaly. These medications are:
- Somatostatin Analogues: Medications like Sandostatin and lanreotide may be used. These medications impairs excessive production of GH and may help in reduction of GH
- Dopamine Agonists: Medications like cabergoline and Parlodel which tend to lower the GH and IGF-I levels
- Growth Hormone Antagonists: Medications like Somavert also helps in blocking the effect of growth hormone on the body.
What Are Some Of The Complications Of Acromegaly?
Some of the complications of Acromegaly are:
- Sleep apnea
- Carpal tunnel syndrome
- Uterine fibroids
- Spinal cord compression
- Vision impairment.