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acromegaly

Alternative Names
hyperpituitarism

Definition
Acromegaly is excessive growth. It is caused by the oversecretion of growth hormone. The condition results in the gradual enlargement of the bones in the face, jaw, hands, feet, and skull.

What is going on in the body?
Overproduction of growth hormones produces changes in many tissues and organs. Acromegaly occurs after normal growth has been completed. In most cases, it begins between the ages of 30 and 50.

What are the signs and symptoms of the condition?
Acromegaly develops slowly. In many people, the changes are so slow that they are not recognised for years. The signs and symptoms of acromegaly include: What are the causes and risks of the condition?
The high hormone levels that lead to this condition are usually caused by a pituitary tumour. This tumor is benign, meaning that it is noncancerous. The pituitary gland is located at the base of the brain. It controls the production and release of several different hormones.

What can be done to prevent the condition?
There is no prevention for acromagaly. However, early treatment may prevent the worsening of any complications from the condition.

How is the condition diagnosed?
It may take years after the first symptoms appear to diagnose acromegaly. This is because the changes caused by too much growth hormone occur slowly. A blood test to measure the levels of human growth hormones (HGH) is helpful in diagnosing this condition. Many people with acromegaly develop high blood glucose levels. Skull x-rays, a cranial CT scan, and a cranial MRI can be done to take pictures of the pituitary gland. They can help the doctor identify a problem with the pituitary gland. Bone x-rays can show thickening of the skull and of the long bones of the body. X-rays may reveal some arthritis in the spine as well.

What are the long-term effects of the condition?
An individual with untreated acromegaly usually has a reduced life expectancy, and may develop premature heart disease.

What are the risks to others?
This condition is not contagious, so there are no risks to others.

What are the treatments for the condition?
The goal of treatment is to stop the overproduction of the HGH. This can be accomplished with surgery, medication, or radiation therapy. Surgery to remove the pituitary tumour corrects the abnormal growth hormone secretion in most people. Radiation therapy helps to shrink the pituitary tumour. Medications such as octreotide and bromocriptine may be used to block the production of growth hormones.

What are the side effects of the treatments?
There are possible side effects with any surgery. These include bleeding, infection, and allergic reactions to the anaesthesia. Side effects are experienced by about one-third of people who are given medications to block the production of growth hormones. These include pain at the injection site, loose stools, abdominal distress, and gallbladder stones. Radiation may cause inflammation of the mucous membranes in the nose and mouth, resulting in soreness and ulcerations. It may also damage normal tissues surrounding the tumour. However, accurate targeting of the radiation can minimise these effects.

What happens after treatment for the condition?
After treatment, periodic evaluation is necessary to ensure the normal functioning of the pituitary gland.

How is the condition monitored?
The person should have yearly medical examinations. Blood tests may be performed to measure the amount of growth hormone present and make sure that it is normal. There is a slight chance that the tumour that caused the acromegaly may recur.

Author: Gail Hendrickson, RN, BS
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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