Growth hormone (GH) controls the growth of soft tissue and bone. Elevated GH causes an excess of bone and soft tissue growth. In adults, this can cause the rare disorders acromegaly. It can cause serious complications and early death if not treated.
In young children, bone fusion and growth is still occurring. Excess GH can cause a similar condition called gigantism.
The pituitary gland is a small gland located at the base of the brain. It produces many hormones including GH.
In most cases, the elevation of GH is caused by a benign tumor of this gland. In a small number of cases, malignant tumors of other organs (pancreas, adrenal, lung) may be the source of excess GH.
Some rare cases are hereditary. The average age of diagnosis is 40-45 years old.
Symptoms usually develop very slowly over time.
In children, the bones are elongated and cause soft tissue swelling. If not treated, children can grow to a height of 7-8 feet.
Symptoms and complications in adults may include the following:
The doctor will ask about your symptoms and medical history. A physical exam will be done. It is often not diagnosed until years after its onset.
Blood tests will be done to measure the level of:
If these tests confirm acromegaly, the following may be done to locate the tumor that is causing the disorder:
The goals of treatment are to:
Treatment may include:
The tumor that is believed to be causing acromegaly may be removed. In most cases, this is the preferred treatment.
External beams of radiation are used to shrink the tumor. It is most often used when surgery cannot be used or when medications have failed.
Drugs may be given to reduce the level of GH secretion. These include:
RESOURCES:
National Institute of Diabetes & Digestive & Kidney Diseases
http://www.niddk.nih.gov/
Pituitary Network Association
http://www.pituitary.org/
Pituitary Tumor Network Association
http://neurosurgery.mgh.harvard.edu/ptna
CANADIAN RESOURCES:
Health Canada
http://www.hc-sc.gc.ca/
Queen's University Department of Opthamology
http://meds.queensu.ca/
References:
Abrams P, Alexopoulou O, Abs R, et al. Optimalization and cost management of lanreotide-Autogel therapy in acromegaly. Eur J Endocrinol. 2007;571-577.
Acromegaly treatment consensus workshop participants: guidelines for acromegaly management. J Clin Endocrinol Metab . 2002; 87:4054-4058.
American Academy of Family Physicians website. Available at: http://www.aafp.org .
Cook DM. AACE Acromegaly Guidelines Taskforce. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of acromegaly. Endoc Pract . 2004;10:213-225.
Glustina A, Barkan A, Casanueva FF, et al. Criteria for cure of acromegaly: a consensus statement. J Clin Endocrinol Metab . 2000;85:526-529.
Melmed S. Medical progress: acromegaly. N Engl J Med . 2006;355:2558-2573.
The Merck Manual of Medical Information . Simon and Schuster; 2000.
National Institute of Diabetes & Digestive & Kidney Diseases website. Available at: http://www.niddk.nih.gov .
Paisley AN, Trainer PJ. Medical treatment in acromegaly. Curr Opin Pharmacol . 2003;3:672-677.
Trainer PJ, Drake WM, Katzneison L, et al. Treatment of acromegaly with the growth hormone-receptor antagonist pegvisomant. N Engl J Med . 2000; 342:1171-1177.
Last reviewed January 2009 by Rosalyn Carson-DeW¹itt, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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