Acromegaly Definition, Reason, Symptom, Treatment, Prevention

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Acromegaly Definition, Reason, Symptom, Treatment, Prevention

Acromegaly Definition

Acromegaly is a condition that arises due to excess growth hormone in the body. Growth hormone, or growth hormone, is a hormone produced by the pituitary gland in the human brain.

In children, growth hormone affects growth and development. Whereas in adults, growth hormone affects energy levels, muscle strength, and bone health.

Excess growth hormone in children is called gigantism and is a very rare condition. In adults, acromegaly is often found in middle age. Acromegaly is also a very rare condition. It is estimated that only three new cases of acromegaly are found in every one million people each year.

Acromegaly Reason

Acromegaly is related to growth hormones. The hormone regulation system in the human body is generally regulated in the form of a cascade. For growth hormone, for example, the cascade begins with the production of growth hormone-releasing hormone (GHRH) by the brain’s hypothalamus.

GHRH will stimulate the pituitary gland to produce growth hormone. The release of this hormone in the bloodstream will stimulate the liver to produce insulin-like growth factor I (IGF-I). High levels of IGF-I will then tell the pituitary gland to reduce growth hormone production.

If the production of growth hormone is excessive, it will result in excess production of IGF-I. This can lead to organ enlargement and excess bone growth. It can also lead to changes in sugar and fat metabolism, which can lead to diabetes, high blood pressure, and heart problems.

In most cases of acromegaly, about 95% of cases, the overproduction of growth hormone is due to the presence of a benign tumor on the pituitary gland called an adenoma. Based on the size, these adenomas can be divided into macro (if larger than 1cm) and micro.

An enlarged adenoma in the brain can also press on certain tissues in the brain (depending on the location of the adenoma) causing certain symptoms.
Although rare, acromegaly can also be caused by tumors in other parts of the body such as the lungs, pancreas, and other parts of the brain. Often, these tumors produce GNRH which causes the production of growth hormone by the pituitary gland. The tumor may also produce growth hormones directly.

Acromegaly Diagnosis

To determine the diagnosis of acromegaly, the doctor will conduct a thorough evaluation by taking a history around the signs and symptoms felt, as well as a physical examination. Investigations that may be needed to support the diagnosis are:

  • Growth hormone levels: an increase in the level of this hormone (>10 ng/ml) after consuming sugar, coupled with clinical signs of acromegaly, can confirm the diagnosis.
  • Oral glucose (sugar) consumption test: assesses growth hormone levels after sugar consumption. Under normal circumstances, sugar consumption will stimulate the pituitary to reduce growth hormone production.
  • When IGF-I.
  • Imaging: MRI or CT- scan to assess the presence of a pituitary adenoma or tumor in other parts of the body. X-ray examination to assess the manifestation of excess growth hormone and IGF-I in bone.

Acromegaly Symptoms

Some of the symptoms or signs of acromegaly that can be recognized include:

  • swelling of the hands and feet (watch for changing ring or shoe sizes)
  • facial changes: eyebrows and lower jaw protruding, there is a space between the teeth, the lower lip and nose are enlarged
  • joint pain
  • the skin on the face and extremities feels rough and oily
  • thick and hard nails
  • Wrinkles on the forehead and the area around the nose-mouth become deeper
  • enlarged skin pores and hyperpigmentation
  • thick and puffy eyelids
  • excessive sweat
  • high blood pressure
  • headache
  • visual impairment
  • Abnormalities in the menstrual cycle, sometimes accompanied by discharge from the breasts
  • erectile dysfunction
  • decreased libido

Acromegaly Treatment

In the case of pituitary adenoma, the recommended treatment for acromegaly is surgery to remove the tumor. Surgery is generally successful in cases of a tumor diameter below 10mm.

Drugs can be given if surgery does not reduce growth hormone levels or can be given in cases of large tumors to reduce their size before surgery. Drugs that may be given are somatostatin analogues, GH receptor antagonists (GHRA), and dopamine agonists.

If after surgery there is still a tumor, and drugs can’t help reduce symptoms, radiation therapy may be considered. According to Osmosis shown in the video What is Acromegaly and the video below:

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