What is Acromegaly?

By Dr Ananya Mandal, MD

Acromegaly is an endocrine disorder where there is a hormonal imbalance in the body. The condition is caused by too much growth hormone (GH).

Pathology

Growth hormone is normally produced by the pituitary gland. This is a small pea-sized gland that lies within the brain. In acromegaly, the pituitary produces excessive amounts of GH.

The excess production may be due to a benign, or noncancerous, tumor on the pituitary. These tumors are called adenomas.

Symptoms of acromegaly

Without treatment acromegaly can cause severe complications and even death. Acromegaly is treatable in most patients. It has a slow and gradual onset and often goes un-noticed in its initial phases.

Acromegaly and other disorders

Acromegaly may lead to other disorders including:

  • type 2 diabetes
  • high blood pressure
  • cardiovascular disease
  • colon polyps that may turn into colon cancers as they progress
  • arthritis

Gigantism and acromegaly

If the disorder occurs in childhood, it leads to gigantism rather than acromegaly.  In children excess growth hormone leads to excess prolongation of the long bones (in the legs) and this leads to excessive height gain.

The long bones in response to the growth hormone especially grow at the growth plates—areas near either end of the bone.  Once the child attains puberty, the growth plates fuse and thus after attainment of puberty excess growth hormone does not lead to gigantism or excessive height gain.

Those with acromegaly usually have no growth of their limbs. However bones of the hands, feet, and face can still grow and these begin to grow. The hands appear like spades. The face bones grow to alter the shape of the face. The jaw becomes larger, with spaces appearing between the teeth, and the eyebrows become more prominent. The skin becomes rough and oily and there is excessive growth of the tongue as well.

Who is affected?

Acromegaly is most often diagnosed in middle-aged adults between ages 40 and 45. Symptoms of the condition may appear at any age. Around 3 to 4 million persons are affected annually.

Treatment

Treatment is targeted towards the pituitary tumor. The tumor may be treated using a combination of surgery to remove the tumour, radiotherapy to destroy any tumour cells and drugs to suppress the production of further growth hormone.

Reviewed by , BA Hons (Cantab)

Further Reading

Last Updated: Oct 7, 2014

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