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).
Carpal tunnel syndrome.
High blood pressure.
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, Endocrinology 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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