Acromegaly/Gigantism Flashcards
What percentage of pituitary tumors are GH-producing tumors?
10%.
What hormone is produced in approximately 40% of somatotroph adenomas?
PRL.
What are common symptoms of hyperprolactinemia?
- Amenorrhea
- Galactorrhea.
What are mammosomatotroph adenomas?
A subset of tumors that produce both GH and PRL.
What clinical condition do GH-producing tumors cause in adults?
Acromegaly.
What clinical condition do GH-producing tumors cause in children?
Gigantism.
What are the most striking features of acromegaly?
- Enlargement of the lower jaw (prognathism)
- Changes in nose and lips
- Frontal bossing.
What oral cavity changes are associated with acromegaly?
- Malocclusion
- Increased spacing between teeth
- Enlargement of the tongue.
What causes a hollow, resonant voice in acromegaly patients?
Changes in the vocal cords and soft tissues of the hypopharynx.
What is a common respiratory issue in patients with acromegaly?
Sleep apnea.
What percentage of patients with acromegaly experience arthritis?
75%.
What is the prevalence of carpal tunnel syndrome in acromegaly patients?
50%.
What cardiovascular issues are associated with acromegaly?
- Increased prevalence of hypertension (25 to 35%)
- Diabetes mellitus (10 to 25%).
Why are random GH level measurements not useful for diagnosing acromegaly?
GH is secreted in a pulsatile manner and normal levels can be large (>50 ng/mL).
What is the most reliable test for diagnosing acromegaly?
Glucose tolerance test.
What do IGF-I levels indicate in the context of acromegaly?
An integrated index of GH production.
What imaging study is preferred for evaluating tumor growth after acromegaly diagnosis?
MRI.
What are the goals of therapy in acromegaly?
- Reverse or prevent tumor mass effects
- Reduce long-term morbidity and mortality from excess GH.
What percentage of patients with microadenomas achieve GH levels lower than 2.5 ng/mL after transsphenoidal surgery?
Approximately 80%.
Name a medical therapy for acromegaly.
- Dopamine agonists (e.g., cabergoline)
- Somatostatin analogues (e.g., octreotide, lanreotide)
- GH receptor antagonist (e.g., pegvisomant).
Is radiation recommended as primary therapy for acromegaly?
No.
What are the risks associated with radiation therapy for acromegaly?
- Long time (5 to 10 years) for GH level reductions
- High incidence of hypopituitarism and other complications.
