Acromegaly

  • Increased GH, ACTH and TSH
  • Rare metabolic condition characterized by bony and soft tissue overgrowth and metabolic hypersecretion

Etiology: Benign pituitary adenoma – chronic hypersecretion of GH, ATCH and TSH

NB: If hypersecretion occurs prior to closure of epiphyseal growth plates, gigantism will occur

Clinical:

A) Systemic:

  1. Hyperhidrosis (increased sweating)
  2. Hirsutism (masculinization)
  3. Impotence
  4. Muscle weakness
  5. Paresthesia
  6. Carpal tunnel syndrome
  7. Sleep apnoea
  8. Hypertension
  9. Heart disease

B) Bone:

  1. New periosteal bone formation
  2. Cartilaginous hyperplasia
  3. Frontal bossing
  4. Nasal bone hypertrophy

C) Oral:

  1. Mandibular prognathism (increase in mandibular condyle)
  2. Acquired malocclusion
  3. Macroglossia

Lab: In serum, increased GH, ACTH, TSH and testosterone

Management:

  • Transsphenoidal surgery
  • Radiotherapy
  • Bromocriptine (dopamine activator)

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