Acromegaly.

 Hyperscretion of GH from pituitary tumours.

Rare.

Causes.

  • Bening pituitary tumour.
  • Can also secrete PRL.
  • GH use in bodybuilders

Usually 30-50 post epiphyseal closure.

Features.

  • Insidious onset.
  • Oily skin.
  • Large tongue.
  • Thick lip.
  • Broad nose.
  • Prominent Supra-orbitla ridge.
  • Increased tooth spacing.
  • Thick large hands.
  • Needing bigger shoes.
  • Deeper voice.
  • Headache.
  • Sweating.
  • Visual field defects.

 

Complications.

  • Mortality x 2 normal.Usually IHD or CVA from RF below.
  • DM Type 2 in 30%.
  • CCF & CM.
  • HTN in 5%.
  • Joint pain – esp. weighht bearing.
  • Carpal tunnel syndrome.
  • Proximal myopathy.
  • CRC increased.
  • OGTT.


PRL effects.

Eventual Pan-Hypo pituitarism.

Tests.

  • GH
  • HbA1c.
  • Prolactin
  • IGF-1.

Treatment.

Treat complications (DM,HTN).

3 routes of Rx.

Surgical.

  • 1st line.
  • Hypopituitarism can result.

Medical.

  • Octreotide (somatostatin analogue).Gallstones. Depot 1/12.
  • Often adjunct to surgery.

RT.