Acromegaly

Question 1

What is acromegaly?

Answer 1

Excessive growth hormone (GH)

Question 2

What gland is acromegaly a disease of?

Answer 2

Anterior pituitary gland

Question 3

What is the most common cause of acromegaly?

Answer 3

Pituitary adenoma causing unregulated GH secretion

Question 4

What visual field defect is typical of acromegaly?

Answer 4

Bitemporal hemianopia due to compression of the optic chiasm

Question 5

What is the presentation of acromegaly?

Answer 5

Prominent forehead and brow
Large nose
Large tongue
Large hands and feet
Large protruding jaw (prognathism)

Question 6

What investigations are done for acromegaly?

Answer 6

IGF-1 - raised in acromegaly
Oral glucose tolerance test + GH measurement (gold standard)
MRI brain for tumour
Referral to ophthalmology

Question 7

What is the definitive treatment for acromegaly?

Answer 7

Trans sphenoidal surgical removal of the pituitary tumour

Question 8

What medication can be used?

Answer 8

Pegvisomant- GH antagonist
Somatostatin (GHIH) analogues- block GH release
Dopamine agonists- block GH release