Acromegaly
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Acromegaly
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Adrenal insufficiency: Pathology review
Adrenal masses: Pathology review
Hyperthyroidism: Pathology review
Hypothyroidism: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Diabetes mellitus: Pathology review
Cushing syndrome and Cushing disease: Pathology review
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Hypopituitarism: Pathology review
Diabetes insipidus and SIADH: Pathology review
Multiple endocrine neoplasia: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
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Acromegaly
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Acromegaly p. 345
carpal tunnel syndrome p. 456
GH p. 340
octreotide for p. 409
somatostatin analogs for p. 335
somatostatin for p. 362
Diaphoresis p. 311
acromegaly p. 345
Heart failure p. 318
acromegaly p. 343
Insulin-like growth factor 1 (IGF-1)
acromegaly p. 343
Insulin resistance
acromegaly p. 345
Octreotide p. 380, 409
acromegaly p. 345
Pituitary adenomas
acromegaly and p. 343
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Transcript
Content Reviewers
Rishi Desai, MD, MPHContributors
Sam Gillespie, BSc
Acromegaly can be broken down into “acro” which refers to extremity and “megaly” which refers to enlargement.
So acromegaly is a hormonal disorder in adults where there is an excess of growth hormone or somatotropin, and causes continued growth of the extremities in adults, leading to large hands, feet and face.
As examples, the French wrestler André the Giant who played Fezzik in the movie The Princess Bride and actor Richard Kiel who played Jaws in the James Bond movies both had acromegaly.
In children, excess growth hormone causes a different disorder, called gigantism, because their long bones haven’t stopped growing yet.
So let’s talk about how growth hormone is made.
Normally, the hypothalamus which is at the base of the brain, secretes growth hormone-releasing hormone in bursts throughout the day - every couple hours, and this can increase based on things like low blood glucose levels, lack of food, increased exercise, increased sleep, and increased stress like trauma.
The growth hormone-releasing hormone goes into the hypophyseal portal system - which is a network of capillaries linking the hypothalamus to the anterior pituitary which is smaller in size than a pea.
The growth hormone-releasing hormone binds to a surface protein on somatotroph cells of the anterior pituitary gland, and in response, they release growth hormone.
The body uses three main ways to help limit the amount of growth hormone that gets made.
First, too much growth-hormone-releasing hormone signals the hypothalamus to stop making more.
Summary
Acromegaly is a rare disorder caused by too much growth hormone (GH) secreted by the anterior pituitary gland, a small organ at the base of the brain. In children, too much GH can lead to gigantism condition characterized by unusually tall stature. In adults, too much GH can cause acromegaly, which results in abnormal enlargement of the head, face, hands, and feet. It is usually accompanied by comorbidities like diabetes mellitus, hypertension, heart disease, and arthritis.
Sources
- "Robbins Basic Pathology" Elsevier (2017)
- "Harrison’s principles of internal medicine" McGraw Hill / Medical (2018)
- "Pathophysiology of Disease: An Introduction to Clinical Medicine, 8e" McGraw Hill (2018)
- "Current Medical Diagnosis and Treatment 2020" McGraw Hill (2020)
- "Harrison's Endocrinology, 4E (Harrison's Specialty) 4th Edition" McGraw Hill (2016)
- "A consensus on the diagnosis and treatment of acromegaly complications" Pituitary (2012)
- "Surgery for acromegaly: Evolution of the techniques and outcomes" Reviews in Endocrine and Metabolic Disorders (2008)
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