Acromegaly Flashcards
What is acromegaly
Excessive Growth Hormone secretion by pituitary adenoma
What is the patho of Acromegaly (GH secretion to metabolic disturbance)
Pituitary adenoma = high GH
High GH = High IGF-1 by liver = Acromegaly
Growth hormone not suppressed by somatostatin
Can cause Type 2 DM through insulin resistance
What hormone normally decreases Growth hormone(Somatotropin)
Somatostatin
What causes increased IGF!
Excess GH
What causes Acromegaly
Pituitary Adenoma
Ectopic Hyperplasia
What are the main signs of Acromegaly
Large hands and feet Outward jaw growth Macroglossia Increased sweating Mood disturbance Erectile dysfunction
What are the investigations for Acromegaly
Measure IGF-1 serum
Measure GH (Oral Glucose tolerance test)
Check tumour - MRI or CT
What is the first line management for Acromegaly
Transsphenoidal surgery
-MEASURE IGF and GH 3 months after
What is the medicinal management for Acromegaly
Somatostatin Receptor Ligand (octreotide inhibit GH)
GH Antagonist (Pegvisomant control IGF)
Dopamine Antagonist (Cabergoline control IGF)
Radiotherapy
What complications can arise from Acromegaly
Visual field defect Type 2 DM Carpal Tunnel Syndrome HTN Colonic Polyps Heart Fail IHD Regurgitant valve Obstructive sleep apnoea
Why can visual field defects occur in Acromegaly
The pituitary adenoma can compress against the optic chiasm
What is obstructive sleep apnoea
Snoring, daytime tiredness and sleep apnoea caused by nasopharyngeal swelling
What is the difference between adult and child acromegaly
Adult = Acromegaly (After epiphyseal fusion) Child = Gigantisism (Before epiphyseal fusion)
What is the Gold standard investigation r acromegaly
Oral Glucose Tolerance Test
