The Giants; myth, reality and science

1. Myth

The film Handia, shot in Basque and directed by Aitor Arregui and Jon Garaldo, has won 10 Goya awards in the 2018 Edition of the awards at the Spanish Film Academy.

The film Handia means Big and tells the story of the giant of Altzo, who lived in the Basque Country in the 19th century and became known throughout Europe.

There has always been interest in these enormous beings and many mythological stories speak of them.

The best known is the War of the Giants, in which the Greek God Zeus himself had to shoot his poisoned arrows to kill them.

There are many fables, tales and legends about giants, but they are also present in almost all cultures.

There are current theories, for many supported by scientific facts, that support the arrival in the past to some human populations of extraterrestrial visitors who experimented with genetic manipulations between both species, resulting in the legendary giants, endowed with superior powers and who, later, with their high technology, would give rise to great cultures such as the Egyptian or the Central and South American.

2. Reality

In a less speculative way, the gigantism was described as a medical alteration by a Dutchman in the year 1567, but it was in the XIX century when well objectified observations were made, and already in the XX century when the present bases of this pathology were sustained.

3. Science

Gigantism is a rare disease, with an incidence of 3 new cases per million people per year, and its fundamental cause is an adenoma of the pituitary gland secreting GH (growth hormone).

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This adenoma or benign tumor produces almost always (98%) only GH, but it can also secrete Prolactin and other hormones in very rare cases.

There are other rare causes of gigantism, such as increased production of GHRH, IGF1, IGFBP3, ectopic GH secretion and other much less frequent syndromes, genetic disorders… Acromegaly has the same origin as gigantism but, unlike gigantism, it appears when the epiphyseal zones of bone growth are already closed.

However, the preferred symptom of gigantism is a longitudinal growth in childhood that is much higher than average.

The symptomatology is diverse, but long arms and legs stand out.

Frontal protrusion, prominent jaw, large hands and feet and many other symptoms and signs of hormonal alteration such as pubertal delay, irregular menstruation, milk secretion in breasts, facial thickening can be observed.

Also in advanced cases, vision disorders, headaches, hyperhidrosis, asthenia.

The diagnosis is also completed with hormonal studies and imaging techniques, MRI of pituitary areas.

Long-term complications can be multiple. Cardiovascular disorders, diabetes M., thyroid pathology, rheumatologic problems.

The usual treatment is transsphenoidal surgery, with good results in general, and to a lesser extent, transnasal endoscopic surgery.

Primary or coadjuvant radiotherapy with surgery and, optionally, drugs, especially somatostatin analogues, such as octeotride, may also be useful.

In any case, these children or adolescents with gigantism and maximum heights around 2.4 meters have nothing to do with those gigantic beings of 4 or more meters, mythological or extraterrestrial that now we cannot know if they really existed.