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Acromegaly

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The Acromegaly is a rare disease that affects one hundred individuals per million people . It is an insidious disease since the symptoms appear progressively and it can take between 7 to 10 years, the realization of a diagnosis.

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What is acromegaly?

Acromegaly is a disease caused by excess secretion of growth hormone . In most cases, the origin of this hormonal disease is linked to the presence of an adenoma, that is, a benign tumor, located in the anterior lobe of the pituitary. The patient with acromegaly presents hypertrophic morphological modifications .

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  • Definition
  • Characteristics of acromegaly
  • Causes
  • Consequences
  • Symptoms of acromegaly
  • Diagnosis
  • Treatments
  • Acromegaly in children
  • Famous with acromegaly

Definition

It is a disease related to an excess production of growth hormone (GH or STH). This is associated with morphological changes such as the growth of the face, hands and feet . It can also affect several organs such as the heart, lung or joints.

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As the course of acromegaly develops rather slowly and the signs are not always very obvious, this disease is usually diagnosed late .

Characteristics of acromegaly

  • Generally, it occurs in adults between 30 and 40 years old .
  • In 95% of cases, it is directly associated with a disorder in the production of growth hormone, a hormone that plays a decisive role in the growth of children and adolescents.

Causes

Acromegaly is caused by 2 main reasons:

  • The hypersecretion of growth hormone due to the presence of a pituitary adenoma. It is a benign tumor, not cancer.
  • As a consequence of hyperactivity in the pituitary , due to the presence of a peripheral cancerous tumor .

In other cases, acromegaly may be hereditary or of unknown origin.

Consequences

  • Modification of facial features.
  • Increase in the size of the feet and hands.
  • Deep voice.
  • Thickening of the tongue.
  • Spacing between teeth.
  • Joint pain
  • Headaches
  • Visual problems.
  • Erectile dysfunction.

Symptoms of acromegaly

The symptoms of acromegaly appear very slowly. In this sense, the diagnosis is made only after many years of disease evolution.

Some of the symptoms are:

  • Increase in the size of the hands and feet . Indeed, a common symptom is that people increase their shoe size as adults.
  • Changes in the appearance of the face . Often the forehead appears puffed, the cheeks, nose and lips appear thickened.
  • Regarding the oral cavity, the teeth tend to be spaced due to the increase in the size of the jaw. Moreover, the tongue becomes thicker.
  • Joint pain or backache .
  • Tingling or itching in the hands . These symptoms are linked to the carpal canal due to thickening of the bones.
  • Other symptoms such as excessive sweating, tiredness, hearing loss, and voice modification.

Diagnosis

As previously mentioned, acromegaly progresses slowly and this causes its diagnosis to be delayed. These are the characteristic clinical signs of the disease that can guide the diagnosis , which will be confirmed by the results of a series of tests , such as those mentioned below.

Growth hormone blood test

The growth hormone blood test is difficult to perform as it is unevenly synthesized by the body. In this sense, it is necessary to carry out this examination several times in order to confirm the diagnosis.

Radiology

Evaluation of the size of the tumor and the extent of the disease is done during an X-ray.

Ophthalmological examination

An ophthalmological examination is performed in order to evaluate the repercussions of the pituitary adenoma on the optic nerves. A compression of the adenoma could thus cause alterations in vision.

Hormonal tests

A blood test for prolactin, sex hormones, and thyroid is performed to determine the impact of the adenoma on the hormones controlled by the pituitary.

Other complementary exams

Other complementary tests are carried out in order to detect eventual complications such as diabetes, colon cancer or high blood pressure.

Treatments

Those who suffer from this disease must be treated by an endocrinologist and the earlier the treatment, the less irreversible consequences. When there is no treatment, the morphological changes worsen and the patient is exposed to developing cancer and reducing his life expectancy.

There are three types of treatment for acromegaly:

  • Surgery: a surgical intervention is the reference alternative in most cases. This allows partial or total removal of the adenoma. This intervention can be done nasal if the size of the tumor allows it. It is the fastest way to lower the level of growth hormone.
  • Medical treatments: There are a number of treatments that can stabilize the level of growth hormone and, in some cases, reduce the size of the adenoma. For example, treatments based on somatostatin, a hormone that inhibits growth hormone, can be given.
  • Radiation therapy: This alternative can regulate hypersecretion but these effects can take between 10 to 15 years. Radiation therapy rays can destroy adenoma cells and block their proliferation system. Radiation therapy after surgery may be considered if the growth hormone level remains high.

It should be noted that these treatments may be accompanied by a psychological follow-up considering that acromegaly can impact the quality of life of patients.

Acromegaly in children

When a child suffers from acromegaly, it is known as gigantism , since its size increases abnormally.

Famous with acromegaly

  • Richard Kiel: This is the actor in charge of playing the role of “Jaws”, one of the antagonistic characters in the popular James Bond movies. His height of 2 meters 17 centimeters made him selected to participate in the film.
  • Carel Struyken : Another actor of great stature due to his suffering from acromegaly, known for his portrayal of Lurch in the movie “The Adams Family .”
  • Fred Gwynne: Popular highly talented actor famous for his role in the television comedy Car 54, Where are you? (1961) and in The Munsters (1964) playing the role of Herman Munster. Besides being very tall, he had a very prominent baritone voice.
  • Tanya Angus : Las Vegas activist who suffered from the most severe case of gigantism on record in the world. At just 34 years old, he died of a transient ischemic attack.

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