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Acromegaly - Detailed Clinical Presentation

Multisystem effects of growth hormone hypersecretion in adulthood.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Endokrinoloji department. Book Appointment →

What is Acromegaly - Detailed Clinical Presentation?

Acromegaly is a rare endocrine disease (incidence 3-4/100,000) caused by growth hormone hypersecretion from a pituitary adenoma in adults. In children and adolescents (before epiphyseal closure), the same pathology causes gigantism. There is usually a 5-10 year diagnostic delay; the average age at diagnosis is 40-50 years.

Clinical findings develop slowly: enlargement of the hands and feet (ring/shoe size increase), coarsening of facial features (frontal bossing, prognathism, macroglossia, dental separation), excessive sweating, oily skin, deep voice, joint pain, carpal tunnel syndrome, sleep apnoea and headaches.

Systemic complications determine mortality: cardiovascular disease (hypertension, biventricular hypertrophy, valvular disease, atrial fibrillation), type 2 diabetes/glucose intolerance (30%), colon polyps and increased colon cancer risk, thyroid nodules, sleep apnoea (60-80%) and arthropathy. With early diagnosis and effective treatment (transsphenoidal surgery, somatostatin analogues, GH receptor antagonist, dopamine agonists), mortality can be reduced to normal levels.

Symptoms

Hand and foot enlargement (ring/shoe size increase)
Coarse facial features (prognathism, frontal bossing)
Macroglossia (large tongue)
Dental separation (diastema)
Excessive sweating and oily skin
Deep voice
Joint pain and arthritis
Carpal tunnel syndrome
Headache, visual disturbance
Sleep apnoea, snoring

Risk Factors

GH-secreting pituitary adenoma (>95%)
MEN1 syndrome
Carney complex
McCune-Albright syndrome
Familial isolated pituitary adenoma (FIPA)
AIP gene mutation
X-LAG syndrome
Ectopic GHRH secretion (rare)

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Increasing ring/shoe size
  • Significant change in facial features
  • Persistent headache, visual disturbance
  • Newly developed diabetes and hypertension
  • Carpal tunnel symptoms
  • Severe sleep apnoea
  • Joint pain and stiffness
  • Excessive sweating, oily skin

Treatment Methods

01
IGF-1 measurement (screening)
02
OGTT-GH suppression test (confirmation)
03
Pituitary MRI
04
Transsphenoidal adenomectomy (first-line)
05
Somatostatin analogues (octreotide, lanreotide)
06
GH receptor antagonist (pegvisomant)
07
Dopamine agonist (cabergoline)
08
Stereotactic radiotherapy (gamma knife)
09
Multidisciplinary follow-up (cardiology, sleep, colonoscopy)

Which Department to Visit?

You can visit our Endokrinoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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