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Acromegaly

Definition

Acromegaly is a rare disorder caused by an excess of growth hormone (GH). GH controls the growth of soft tissue and bone. Too much GH results in bones and tissues that increase in size.

Young children are still growing. Excess GH can cause a similar health problem called gigantism. This causes dramatic growth in children.

Causes

This problem happens when the pituitary gland in the brain makes too much GH. This may happen due to:

Pituitary Gland
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Risk Factors

This problem often starts around 45 years of age. Rarely, family history may increase the risk of this problem.

Symptoms

Symptoms usually start slowly over time.

In children, the bones grow longer and cause soft tissue swelling. If not treated, children can grow to a height of 7 to 8 feet.

Problems in adults may be:

  • Abnormally large growth and deformity of the:
    • Hands—rings no longer fit
    • Feet—need a bigger size shoe
    • Face—bulging of brow and lower jaw
    • Jaw—teeth do not line up correctly when the mouth is closed
    • Lips
    • Tongue
  • Skin changes, such as:
    • Thickened, oily, and sometimes darkened skin
    • Severe acne
    • Excess sweating and unpleasant body order
  • A deep voice
  • Problems sleeping
  • Swelling in the neck
  • Fatigue and weakness in the legs and arms
  • Joint pain, especially in the jaw
  • In women:
    • Irregular menstrual cycles
    • Abnormal production of breast milk
  • In men—problems maintaining an erection

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done.

You will have blood tests.

Images may be taken of the body. This can be done with:

Treatment

The goals of treatment are to reduce GH levels and ease symptoms. Choices are:

  • Medicines to lower the level of GH
  • Medicine or radiation therapy to reduce the tumor
  • Surgery to remove the tumor

Prevention

There are no current guidelines to prevent acromegaly.

RESOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

Pituitary Network Association
http://www.pituitary.org

CANADIAN RESOURCES:

Canadian Society of Endocrinology and Metabolism
http://www.endo-metab.ca

Health Canada
https://www.canada.ca

REFERENCES:

Acromegaly. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acromegaly. Accessed October 29, 2020.

Katznelson L, Atkinson JL, et al; American Association of Clinical Endocrinologists. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of acromegaly - 2011 update. Endocr Pract. 2011 Jul-Aug;17 Suppl 4:1-44.

Last reviewed September 2020 by EBSCO Medical Review Board James P. Cornell, MD  Last Updated: 4/28/2021