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Updated 26 February 2019

Acromegaly 101

When your growth hormone goes out of whack.

For your skeletal muscles to grow, the growth hormone (GH) is released. If it’s produced excessively though, a condition called acromegaly is caused. With acromegaly, there’s an overgrowth of tissue.

It’s a rare condition, only found in three to four people per a million annually. Young adults are most affected and if left untreated, it could lead to other serious conditions like diabetes, heart disease and even death. What causes it?The pituitary gland has a small benign tumour called an adenoma that’s found in the middle of the head, just below the brain. If this tumour makes too much GH then acromegaly is the result. 

Common symptoms include:

  • Coarsely enlarged hands, feet, face, jaw, lips, tongue and fingers, with thickened skin.
  • Joint pain and decreased joint mobility, carpal tunnel syndrome
  • Muscle weakness
  • Fatigue
  • Headache, hoarseness and excessive sweating and sebum production.

How is it treated?

Treatment for acromegaly aims to normalise the levels of GH to manageable levels that won’t interfere with growth in the body. Most treatments aim to remove or shrink the tumour that causes the excessive GH hormones that are released. Surgery is the treatment of choice, especially if there are visual problems.

In very large tumours, surgery may be used to remove as much tumour as possible so that the small amount left behind can be treated by other means. 

Surgery
In experienced hands, surgery is highly successful: it normalises growth hormone levels and has a very low recurrence rate. Some highly specialised surgeons can now do this procedure working through the nose using an endoscope, with excellent results.

Complications of surgery can include spinal fluid leak, diabetes insipidus, and meningitis.Medical treatment is preferred for patients whose surgical risk is too high, or as post-operative additional therapy.

Their success rate is about half that of surgery, but they can help to shrink the tumour somewhat.

Radiotherapy

Radiotherapy can be used for tumours uncontrolled by surgery or medical means. Tumour shrinkage is good, but there is a high incidence of abnormal pituitary function afterwards.

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2019-11-18 06:57
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