Acromegaly Flashcards
Where is growth hormone produced?
Anterior pituitary gland
What is the most common cause of unregulated growth hormone secretion (acromegaly) ?
Pituitary adenoma
Which cancers can cause secondary acromegaly?
Lung cancer
Pancreatic cancer
What is bitemporal hemianopia?
A loss of the outer half of the vision in both eyes due to compression of the optic chiasm
What can a space-occupying pituitary tumour cause?
Headaches
Visual field defects
(bitemporal hemianopia)
What are the common features of acromegaly?
Prominent forehead and brow
Coarse, sweaty skin
Large nose
Large tongue (macroglossia)
Large hands and feet
Large protruding jaw (prognathism)
Name some additional clinical features of acromegaly?
Hypertension
Carpal tunnel syndrome
Arthritis
Type 2 diabetes
What can indicate the growth hormone level and is raised in acromegaly?
Insulin-like growth factor-1
What is a growth hormone suppression test?
Consuming a 75g glucose drink with growth hormone tested at baseline and 3 hours following the drink
What should a growth hormone suppression test do?
The glucose should suppress the growth hormone
What is used to diagnose a pituitary adenoma?
MRI of the pituitary
What is the definitive treatment of acromegaly secondary to pituitary adenoma?
Trans-sphenoidal surgery
If surgery is not suitable what other treatment options are available?
Pegvisomant - growth hormone receptor antagonist via subcutaneous injection
Somatostatin analogues - block growth hormone release
Dopamine agonists - block growth hormone release
What is somatostatin also known as?
A growth hormone-inhibiting hormone
Where is somatostatin secreted from?
The brain, gastro-intestinal tract and pancreas
What does dopamine do to growth hormone release?
Inhibitory effects
