Acromegaly is a hormonal disorder that develops when your pituitary gland produces too much growth hormone during adulthood

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

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

8.  Enlarged tongue, hands, and feet.
 Weight gain
 Joint pain and muscle weakness.

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

10.  Sleep apnea
 Arthriris and carpal
tunnel syndrome
 Infertility
 Vision loss
 Fatigue

11.  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

12.  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.

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

14.  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

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

16.  There is no way to prevent acromegaly.