Acromegaly Flashcards
excess of what? where is this usually secreted?
growth hormone. secreted from pituitary
usually caused by what pathology
GH secreting pituitary adenoma. usually macro
ix acromegaly
insulin growth factor (initial screen)
glucose tolerance test
NB random GH not done because can get it wrong
what is shown in glucose tolerance test and why
no decrease in GH, (GH secretion is normally suppressed with increased glucose))
what happens to insulin growth factor 1
increases (GH stimulates IGF-1 production)
why is MRI done
look for pituitary adenoma
complications of acromegaly
HF
CHD
hypertension
neoplasia
onset
slow. diagnosis is usually 4-7 years after onset of excessive GH secretion
male of female more
equally affected
presentation
- headaches (due to mass)
- visual field defect
- increase in ring/shoe size
- macroglossia (large tongue)
- large jaw
- coarsening of facial features
- frontal bossing
- excessive sweating common
- mild hirsitism
- T2DM
- osteoarthritis
- carpal tunnel
- hypertension
commonest visual field defect
bitemporal hemianopia
what may also be secreted by the tumour
prolactin -> galactorrhoea and amenorrhoea
increased risk of what cancers
colon, thyroid
rx
trans sphenoidal surgery first line. radiotherapy if refractory
med options if not suitable for surgery: somatostain analogues (octreotide), dopamine agonists (bromocriptine, cabergoline)
