Acromegaly

Question 1

Acromegaly

Answer 1

a hormone disorder in adults where there is excess growth hormone (somatotropin)
• continued growth of extremities -> large face, hands and feet

Question 2

Impacts of growth hormone - DIRECT EFFECT

Answer 2

1. Liver releases more glucose into the blood
2. Body retains more nitrogen in muscles leading to muscle growth
3. Osteoblasts are stimulated causing bones to thicken
4. Daibetogenic effect - increase in blood insulin levels like diabetes

Question 3

Impacts of growth hormone - INDIRECT EFFECT

Answer 3

1. GH stimulates certain tissue like liver, muscles, bones, kidney
2. Produce somatomedin C (insulin like growth factor 1)
   • Promotes cellular metabolism
   • Prevents cell death
   • Helps cells divide and differentiate through out the body

Question 4

Causes of Acromegaly

Answer 4

1. pituitary adenoma
• Benign tumor of somatotrophs in the anterior pituitary
-> makes excess GH
-> excess insulin like growth factor 1
2. Hypothalmic tumors
-> excess GHRH released
3. Ectopic tumors elsewhere in the body
4. Multiple endocrine neoplasia Type 1 
( Wermer Syndrome)

Question 5

Symptoms of acromegaly

Answer 5

May take years to be recognised

1. Growth of bones, hands, feet and lower jaw
2. protrusion of the forehead
3. Soft tissue swelling in hands,feet, face and tongue
4. Increase size of organs
5. Excess swelling

Question 6

Assoc conditions risk factors

Answer 6

1. Carpal Tunnel syndrome - increased pressure on nerves from muscle growth
2. diabetes mellitus - diabetogenic effects from GH
3. Congestive heart failure - enlarged heart
4. Gastrointestinal cancer - colon polyps

Question 7

Diagnosis

Answer 7

1. Elevated levels of insulin like growth factor 1 and growth hormone
2. MRI - confirms pituitary tumor

Question 8

Treatment

Answer 8

1. Surgery - pituitary adenoma removed

2. Medication - somatostatin anologs / Growth hormone antogaonist to stop GH binding to target tissues