Acromegaly – A Hormonal Condition

Acromegaly is a hormonal condition in which the body produces too much growth hormone which leads to excess growth of body tissues over a period of time and is mostly common in middle aged adults but extremely rare in children.

The name `acromegaly’ is derived from the Greek word `extremities – acro and `great’ – megaly due to the common symptom of this condition in abnormal growth of the hands and feet.It is a serious systemic condition which is caused in over 98% of cases by benign tumour – adenoma of the pituitary gland which secretes excessive growth hormone-GH. Growth hormone is produced and released by a pea sized gland just below the brain known as the pituitary gland and when growth hormone is released in the blood, it tends to stimulate the liver in producing another, hormone insulin like growth factor 1 – GF-1.

This is responsible for the growth of muscles, bones and the cartilage in the body, the process of which is essential for the growth as well as the repairs of the body tissues. Negligence on the treatment of acromegaly may result in marked bony and soft tissue changes including altered facial appearance, enlargement of the hands and feet, carpal tunnel syndrome, and sleep apnea.

Symptoms Vary and Differ Gradually

Besides this, other serious problems may occur like accelerated cardiovascular disease, diabetes mellitus hypertension and the possibility of a risk of colon cancer. If the tumour tends to develop before the completion of bone growth in adolescence, it may lead to gigantism due to the serious systemic changes resulting from growth hormone for which treatment need to be done with transsphenoidal surgery.

The symptom of acromegaly may vary and develop gradually and hence a diagnosis of this ailment may be difficult to detect. Some of the typical features may include large, prominent facial features, abnormally large hands and feet, tall height if it takes place before puberty and an enlarged tongue.

The diagnosis of this ailment is detected by demonstrating elevated levels of growth hormone and insulin like growth factor. Lack of suppression of growth hormone to oral glucose administration is mostly used to confirm excess GH production. On confirmation of the biochemical of acromegaly, a MRI of the pituitary needs to be performed to check the presence of pituitary adenoma.

Removal under General Anaesthesia

Acromegaly is treated to reduce excess growth hormone bringing it to normal levels, to relieve the pressure which the tumour exerts on the surrounding structures, to treat any hormone deficiencies and to improve the symptoms of acromegaly most of which is done through surgical removal of the tumour together with medication.

The possibility of surgery may be needed to remove the adenoma in the pituitary gland which helps to correct the excess growth hormone in the patient though at time the tumour may be too large to remove it entirely. Removal of the gland is done under general anaesthesia wherein an incision is made through the nose or inside the upper lip to access the gland.

The person experience prompt relieve of pressure on the surrounding structures on removal which leads to a rapid lowering of growth hormone levels.