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What is Acromegaly? |
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Symptoms
The term ‘acromegaly’ basically implies an enlargement of the extremities; the earliest symptoms of the condition involve a prolonged swollenness of the hands and feet, as the patient tends to outgrow shoe sizes quicker than usual. The facial features are altered as well, as evidenced by a protruding brow and jaw, an enlarged nasal bone structure, and wider gaps on the teeth. This sudden growth in bone mass commonly results in arthritis; the nerves are also trapped as the tissue masses thicken, resulting in carpal tunnel syndrome. The hands may feel numb and feeble, and the internal organs may enlarge. These cause a number of functional symptoms, such as sleep apnea, a deep voice, impaired vision, and erectile dysfunction.
Causes
Acromegaly is a disorder of enlarged extremities, as caused by an overproduction of the growth hormone in a person’s body. The pituitary gland is responsible for the secretion of this hormone, as well as several other hormones which are key elements to the proper regulation of the body’s growth, regeneration, and metabolism – these are usually produced in succession, each affecting the other’s level of secretion into the bloodstream. If the growth hormone is secreted in excess, it stimulates the others to adjust accordingly, causing an enlargement of internal organs and an overdeveloped bone structure. Many cases of acromegaly also result from non-malignant tumors on the gland, called adenomas, and if this case occurs in early childhood, it is referred to as gigantism.
Diagnosis
The patient’s potential for bearing acromegaly may be determined in the bloodstream, and a physician can look for an abnormal elevation by measuring the levels of the growth hormone in the blood. But since the growth hormone is secreted in spurts, these levels can change at any given minute, and the physician may opt for a more reliable method: a glucose tolerance test which measures the levels of either the growth hormone, or of the insulin-like growth factor I, a derivative hormone which promotes tissue growth. These tests are then followed by either a CT or MRI scan for the purpose of detecting ectopic or pituitary tumors, those which are responsible for the overproduction of the growth hormone.
Treatment Info
Acromegaly may be treated through surgical procedures, chemotherapy, or radiation therapy. Transsphenoidal surgery is usually the first course of treatment in many cases due to its efficiency. The surgeon removes the tumor by entering the nose or the upper lip with a minor incision, immediately relieving the pressure on the adjacent regions of the brain, and consequently reducing the production of the growth hormone. Chemotherapy is usually employed as a secondary treatment, or as a means of reducing the size of larger tumors prior to surgery. The medication falls into any of three drug groups: somatostatin analogs, GH receptor antagonists, and dopamine agonists. To maintain the improvement following surgery or chemotherapy, the doctor may also employ radiotherapy if there still remain traces of the original tumor which prove to be resilient with the medication; stereotatic delivery is the method preferred by many doctors since it projects the beam with precision from various angles, a vast improvement from conventional radiotherapy.
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