1. Acromegaly
By Kelsie Bonow

2. Acromegaly Greek words “extremities” and “enlargement”
Hormonal disorder – excess growth hormone (after puberty)
Results in enlargement of body tissues
Genetic alteration, not present at birth
After growth plates have fused, does not affect height
Brow and lower jaw protrude, nasal bone enlarges, teeth space out
Spontaneous, not inherited

3. Etiology Benign tumor of pituitary gland (adenoma)
Body continues to produce growth hormone (GH)
IGH-I levels rise
Bone overgrowth, tissue enlargement
Non-pituitary tumors
Genetic alteration in pituitary cell, increased cell division, tumor
Can affect production of other hormones, location of tumor
Pancreas or lungs, produce GH or growth hormone-releasing hormone
Maurice Tillet – aspiring actor, fled France, professional wrestler in America

4. Signs and Symptoms - VISIBLE
Abnormal growth of hands and feet
Swelling – change in ring or shoe size
Enlarged jaw, tongue, and facial bones
Widely spaced teeth
Skin tags, skin and body odor, and thickening of skin
Skin and body odor, excessive sweating
Hoarseness

5. Signs and Symptoms – NOT VISIBLE
Headache
Fatigue and weakness
Carpal tunnel
Joint pain
Abnormal menstrual cycle and erectile dysfunction
Deepening of voice
Sleep apnea
Impaired vision
Enlarged sinuses and vocal cords

6. Diagnostics Blood tests Imaging GH level Oral glucose tolerance test
IGF-I levels
Imaging
Magnetic resonance imaging (MRI)
Computerized tomography (CT)
GH level not enough, secreted in spurts, level varies often
Oral glucose – drink glucose, lowers GH, not w/ acromegaly
Elevated IGF-I almost always indicate acromegaly
MRI most sensitive
CT if unable to have MRI

7. Treatment Surgery Medical Therapy Radio Therapy 1st option
Rapid and effective
Experience of surgeon
Medical Therapy
Used if surgery is not a cure
Shrinks tumor before surgery
Somatostatin, GHRAs, dopamine agonists
Radio Therapy
Tumor remaining after surgery
Do not respond to medication
If surgery successful, improvement with a few days
Risk of damage to surrounding tissue, rarely meningitis
Somatostatin slows GH production
GHRAs normalize IGF-I levels

8. Prognosis Surgery successful in most patients
55 – 80% overall remission rate after surgery
If left untreated..
Symptoms worsen
Arthritis
Cardiovascular disease
Diabetes
High blood pressure
Vision abnormalities

9. Prevention
There are no methods to prevent this condition, it is spontaneous.
Early treatment may prevent further complications.