Acromegaly

What is acromegaly?

Acromegaly is a hormonal disorder caused by excessive production of growth hormone by the pituitary gland, the consequences of which are mainly visible by an increase in bone size throughout the body.

It is a pathology that usually affects adults around the age of 40 years without distinction between men and women and due to its slow progression is not detected early.

Prognosis of the disease

The disease has a slow development, so it is necessary to act as soon as possible to avoid complications that could become fatal.

Once treatment is initiated, in most cases life expectancy is similar to pre-disease levels, although there are still disorders that generally reduce the quality of life of the subject.

Acromegaly affects both men and women and usually develops after the age of 40.

Symptoms of acromegaly

The disease develops slowly, so the first signs may not be detected for years. The main symptom of the presence of the disease is the growth of the hands and feet, which is manifested by rings or shoes that no longer fit.

Another typical sign is a change in the physiognomy of the face, which presents an increase in the supraorbital arches, nose, lips and a lengthening of the jaw with consequent malocclusion.

Other symptoms include: excessive sweating, oily skin, vision alterations, limited and painful movements of the joints up to carpal tunnel, generalized fatigue with muscular pain, enlargement of the organs, deepening of the voice due to the modification of the vocal cords, nocturnal snoring, development of pendulous fibroids. In addition, in women it presents with alterations of the menstrual cycle, including amenorrhea, while in men it causes erectile problems.

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Diagnosis of acromegaly

The disease is identified mainly by objective analysis and is accompanied by clinical examinations. MRI and CT scans are useful for detecting the presence of pituitary tumor, while analysis of growth hormone and insulin-like growth factor (IGF-1) levels determines whether there is indeed hormone overproduction.

A particularly reliable test is also the analysis of growth hormone levels before and after administration of a glucose preparation. If there is no decrease of the hormone with the administration of the liquid, it means that there is no actual presence of the disease.

What are the causes of acromegaly?

Acromegaly is the consequence of a long-term overproduction of growth hormone (GH), a substance secreted by the pituitary gland, a gland located in the brain in the area behind the nose. In children this hormone allows for proper skeletal development, while in adults it maintains the proper functioning of muscles and bones.

An excess production of the hormone is usually due to a benign tumor of the pituitary gland itself, which produces the above symptoms. In rarer cases, the tumor may affect other organs such as the lungs, pancreas or adrenal glands, which release a hormone that in turn stimulates the pituitary gland to produce GH.

Less frequently, the disease occurs after taking muscle-building drugs, especially in athletes involved in bodybuilding.

Treatments for acromegaly

The cure for acromegaly is based on lowering growth hormone levels and parallel removal of the tumor affecting the pituitary gland. Through transsphenoidal surgery, i.e. through the nasal cavity, most of the cancerous cells affecting the gland are removed.

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If tumor cells remain after surgery, radiation therapy will be performed, the side effect of which will also be the reduction of GH levels. The latter, however, is a treatment whose results may be delayed for a few years before they become visible, as well as causing side effects on the hypothalamic-pituitary axis.

Which specialist should be consulted?

The endocrinologist is the specialist to contact in case of symptoms of acromegaly. In cases where it is necessary to remove the tumor, the intervention of a surgeon will be necessary.