Growth Hormone Excess-Acromegaly


In adults, excessive growth hormone is usually due to a pituitary tumor and causes a constellation of symptoms and signs, known as Acromegaly.  



Clinical features of Acromegaly  



Coarsening of facial features

(develops slowly; comparison to an old picture is helpful).


Enlargement of jaw and tongue.




Separation of teeth.


Excessive soft tissues in palms ("pillowy" feel upon handshake).


Excessive soft tissues in feet (increase in shoe size).


Thickening of fingers (a ring may no longer fit).


Excessive perspiration.




Skin tags.


Carpal tunnel syndrome.


Joint pains.


High blood pressure.




Enlarged heart.


Kidney stones.


Increased risk for colon cancer.  




Diagnosis of Acromegaly  



Measuring  serum IGF-1 is a good screening test for Acromegaly in suspected cases.


Confirmation of the diagnosis of Acromegaly is carried out with an Oral Glucose Challenge test.


These tests should be carried out in consultation with an endocrinologist.  




Treatment of Acromegaly  



In most case, treatment of Acromegaly is surgical removal of the pituitary tumor followed by radiation therapy.


If surgery is contraindicated due to other medical reasons, then medical therapy with a drug called Octreotide is quite effective.    













This article was written by Sarfraz Zaidi, MD, FACE. Dr. Zaidi specializes in Diabetes, photoEndocrinology and Metabolism.


Dr. Zaidi is a former assistant Clinical Professor of Medicine at UCLA and Director of the Jamila Diabetes and Endocrine Medical Center in Thousand Oaks, California.





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