Acromegaly: Treatment, symptoms, advice and help
Acromegaly is a hormonal disorder, caused by increased production of the growth hormone. This increase in growth hormone causes certain bony changes in the body resulting in inappropriate physical growth and some serious complications.
Acromegaly: Incidence, age and sex
Acromegaly is most commonly seen in middle aged people. There is no gender difference in the prevalence. Occasionally this disorder may also be seen in children, where it is termed as Gigantism.
Signs and symptoms of acromegaly: Diagnosis
The earliest symptom of acromegaly is the increase in size of the hands and feet which signify the underlying bony and tissue changes. These changes of abnormal growth are not restricted to just hands and feet but also involve various other parts of the body, especially the face. Acromegalics have distinctive facial features like enlarged lips, large nose, protruding jaw and prominent forehead, which make them resemble each other more than their siblings. Certain skin changes occur such as the thickening and coarseness of skin especially that of the palms. As well as this, acromegalics complain of increased sweating which is due to the increase in size of their sweat glands. Overgrowth of bones and cartilage cause early onset of arthritis, leading to joint pain. Menstrual abnormalities in women and erectile dysfunction in men have also been observed.
Causes and prevention of acromegaly
Augmented production of growth hormone is the root cause for this disorder. The growth hormone which is responsible for the physical growth of human body is produced by a small organ called the pituitary gland situated in the brain. The most common cause of acromegaly is an underlying tumour of the pituitary gland which causes excessive synthesis of growth hormone. These pituitary tumours, in most instances, are benign in nature.
Complications may arise due to the compression of surrounding tissues and structures leading to headache, exhaustion and in some cases, breath-holding spells during sleep. Compression of certain nerves often leads to numbness and weakness in the legs. Vision may also be impaired if the pituitary tumour compresses the nerves supplying the eye. Other serious and long-term complications include diabetes mellitus, high blood pressure, the risk of heart disease, arthritis and rarely, colonic polyps.
The diagnosis of acromegaly can be confirmed by a simple blood test which shows elevated levels of growth hormone after glucose drink. Imaging techniques like an MRI scan is helpful in diagnosing pituitary tumours. The goal of treatment is to diminish the excess production of growth hormone and minimise the effects of pituitary tumour on the adjacent structures. Keeping this in mind, the most appropriate treatment is a surgical removal of the pituitary tumour. Drug treatment and radiation therapy are other treatment modalities which can help in suppressing the growth hormone production. But they are not quite effective on their own. They are usually considered as adjuncts to surgical treatment. Drugs help by shrinking the tumour before surgery and after surgical removal of the tumour radiation therapy is usually required as a follow up treatment.