Acromegaly

What is acromegaly?

Acromegaly is the Greek word for "extremities" and "enlargement." When the pituitary gland produces excess growth hormones, excessive abnormal growth occurs. This is called acromegaly. The excessive growth occurs first in the hands and feet, as soft tissue begins to swell. This rare disease affects mostly middle-aged adults. Untreated, the disease can lead to severe illness and death.

What causes acromegaly?

Overproduction of growth hormone (GH) by the pituitary gland over a long period of time causes acromegaly. There are several reasons for overproduction of GH. The most common reason is the presence of a pituitary adenoma, which is a benign (noncancerous) tumor of the pituitary gland. These tumors produce excess GH.

According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), more than 95 percent of people with acromegaly have a pituitary adenoma.

Tumors outside the pituitary gland can also cause acromegaly, but this is rare.

What are the symptoms of acromegaly?

Symptoms of acromegaly vary depending on how long the patient has had the disease. The following are the most common symptoms of acromegaly. However, each individual may experience symptoms differently. Symptoms may include:

• Swelling of the hands and feet

• Facial features become coarse as bones grow

• Body hair becomes coarse as the skin thickens and/or darkens

• Increased perspiration accompanied with body odor

• Protruding jaw

• Voice deepening

• Enlarged lip, nose, and tongue

• Thickened ribs (creating a barrel chest)

• Joint pain

• Degenerative arthritis

• Enlarged heart

• Enlargement of other organs

• Strange sensations and weakness in arms and legs

• Snoring

• Fatigue and weakness

• Headaches

• Loss of vision

• Irregular menstrual cycles in women

• Breast milk production in women

• Impotence in men

The symptoms of acromegaly may resemble other conditions or medical problems. Always consult your physician for a diagnosis.

How is acromegaly diagnosed?

Due to the subtlety of the symptoms, acromegaly is often not diagnosed until years later. In addition to a complete medical history and medical examination, diagnostic procedures for acromegaly may include:

• Serial photos taken over the years (to observe physical changes in the patient)

• X-rays (to detect bone thickening)

• Blood tests (to check the growth hormone level)

How is acromegaly treated?

Specific treatment for acromegaly will be determined by your physician based on:

• Your age, overall health, and medical history

• Extent of the disease

• Your tolerance for specific medications, procedures, or therapies

• Expectations for the course of the disease

• Your opinion or preference

Treatment of acromegaly depends on the cause of the disease. More than 95 percent of acromegaly cases are caused by benign tumors on the pituitary gland. Because the tumor is compressing the pituitary gland, the hormone production can be altered by removing or reducing the size of the tumor. Some other acromegaly cases are caused by tumors of the pancreas, lungs, or adrenal glands.

The goal of treatment is to restore the pituitary gland to normal function, producing normal levels of growth hormone.

Treatment may include removal of the tumor, radiation therapy, and use of a growth hormone-blocking drug.

Left untreated, acromegaly can lead to diabetes mellitus and hypertension. The disease also increases a patient's risk for cardiovascular disease and colon polyps that may lead to cancer.