Acromegaly description causes treatment.

Acromegaly description causes treatment

1. Acromegaly Harivarshan Arumugam

2. INTRODUCTION Acromegaly is a disorder that results from excess growth hormone (GH) after the growth plates have closed • Acr /o = extremities. •- megaly = enlargement. •Rare disease of the pituitary gland in the brain. •Caused by a benign tumor.

3. Pituitary Gland Pituitary gland is a pea-sized gland that releases and regulates several hormones, including human growth hormone (HGH) that is responsible for regulating growth.

4. Causes It is not uncommon to find pituitary tumors. 1 out of 10 people have tiny tumors in the pituitary gland (pituitary adenoma) , but only 3.5 per million people develop acromegaly About 98% of cases of acromegaly are due to the overproduction of growth hormone by a benign tumor of the pituitary gland called an adenoma Other tumors. tumors of the pancreas, lungs, and adrenal glands

5. Acromegaly vs. Gigantism If the hypersecretion of HGH occurs before to epiphyseal plate closes at puberty, it is called gigantism. Gigantism causes a growth in height, whereas acromegaly causes one's features and extremities to grow larger and wider.

6. Symptoms Symptoms include changes in voice Changes in face features, such as jaw, nose, and forehead Excessive facial hair in women

7. Symptoms Enlarged tongue, hands, and feet. Weight gain Joint pain and muscle weakness.

8. Complications Diabetes Mellitus due to excess insulin-like growth factor-I (IGF-1). Kidney failure Enlarged Heart Hypertension Heart failure

9. Complications Sleep apnea Arthriris and carpal tunnel syndrome Infertility Vision loss Fatigue

10. Diagnosis Magnetic resonance imaging (MRI) or computed tomography (CT) scan Blood test for elevated level of GH or somatomedin -C (IGF-1) In normal subjects, plasma GH suppresses to below 0.5 µg/L (approximately 2 mU /L).In acromegaly, GH does not suppress and in about 30%of patients there is a paradoxical rise; IGF-1 is also elevated

11. Treatment Trans- sphenoidal surgery is usually the frst line of treatment and may result in cure of GH excess Treatment is successful depending on the size of the tumor1 cm by 1 cm in size has a higher cure rate Larger size tumors lower the cure rate Surgical removal of the tumor.

12. Treatments Gamma Knife cobalt Cyber Knife Hormone-regulating therapy Somatostatin analogues (such as octreotide or lanreotide )

13. Treatment Pegvisomant is a peptide GH receptor antagonist administered by daily self-injection and may be indicated in some patients whose GH and IGF-1 concentrations fail to suppress suffciently following somatostatin analogue therapy Dopamine agonists are less effective at lowering GH but may sometimes be helpful

14. Treatment HGH levels and soft tissue* enlargement are not expected to return to normal right away. *Note bony tissue growth cannot be undone.

15. Prevention There is no way to prevent acromegaly.