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Acromegaly
Get the facts on Acromegaly treatment, diagnosis, staging, causes, types, symptoms. Information and current news about clinical trials and trial-related data, Acromegaly prevention, screening, research, statistics and other Acromegaly related topics. We answer all your qestions about Acromegaly.
Question: How would someone know if they had acromegaly, what are the symptoms other than facial enlargement?
Answer: Acromegaly itself is a disorder characterized by excess growth hormone.
Symptoms often include abnormally large bones in the arms, legs, and head. The jaws and the front of the skull and most often affected. It may also cause thickening of the soft tissues of the body, esp. the heart and accelerated growth leading to tall stature.
Acromegaly is most often caused by the growth of a benign (innocent) tumor affecting the pituitary gland.
Question: What is the relation of acromegaly to homeostasis? help!!
Answer: Homeostasis is the maintenance of a constant internal cell environment. This environment is constantly turning into an unbalanced state and if the body can not react in time to return to a balanced state it can cause permanent damage to the body. This happens when there is a hyper (over) secretion of growth hormone in the adult body.This causes acromegaly. Excess growth of the lower jaw, hands, feet, lips and nose.
Question: Elevated fasting glucose level and IGF-1 level in Acromegaly? I want to know how the glucose level and IGF-1 level elevate in acromegaly condition.
( I want the mechanism of anti-insulin action of GH)
Thanks in advance.
Answer: http://www.humatrope.com/common_pages/moa.jsp
Question: I think I am suffering from Acromegaly help me? According to MRI reports I have adenoma of 4*3mm.Prolactin levels=423 & gh levels=0.13. Big hand and feet,Space in teeths,Sweating always,facial looks changed,Diabaties,anxiety,vision problem. Is it acromegaly?or what. Pakistani Doctors are not able to diagnose my problem they only take out my photos.help me
Answer: Consult an Endocrinologist and he may evaluate the adenoma and may suggest either surgery immediately or will treat you with depot formulation of Octreotide (Sandostatin LAR) which will shrink your tumor and improve your condition
Question: When the entire pituitary gland is removed...to treat acromegaly? how come they say that a post op complication is Diabetes Inspidus? If the WHOLE pituitary is removed (hypophysectomy) wouldn't you expect that you wuold have diabetes inspidus?? !@!@
I guess I am confused about the definition of pituitary gland. When they talk about it, Im thinking the whole gland. anterior and posterior.
Also if they get the hypophysectomy, how come growth hormone isnt replaced
Answer: If the entire pituitary is removed then diabetes insipidus may be an expected consequence since it is caused by deficient ADH production and this hormone, although produced in the hypothalamus, it´s stored in posterior pituitary and released from there to the blood.
Growth hormone is produced in the anterior pituitary and if this is removed where should GH come from?
Question: Health conditions on Acromegaly after surgery? What are the chances of survival with Acromegaly after surgery
Answer: Acromegalics do very well after surgery! They often require certain medications to replace what may be lacking after the pituitary glad is removed, but, in general they do well. Since it is such a rare condition, I have only personally had 2 patients with acromegaly. One has to take thyroid replacement, the other is doing well without any medications as of this time. Best wishes!
Question: Even though Andre The Giant knew of his disease, pituitary gigantism/acromegaly,why didn't he seek treatment? Andre was diagnosed with acromegaly before he even moved to Montreal, so why didn't he seek treatment later in life? By the time he lost to Hogan @ wrestlemania he weighed in at about 525lbs. and he hurt all over and still didn't get treatment.
Answer: i don't beleive there was a cure or treatment at the time
Question: help me relate acromegaly,prolactinoma,pituitarytumour,gigantism and dwarfism with their effect to the society
Answer: They help give endocrinologists a job.
Question: Growing To TALL / ACROMEGALY? What causes acromegaly?
Answer: i just did a gigantism project .. and i got some info on acromegaly .. in gigantism during childhood, GH (growth hormone) causes thickening of the epiphyseal cartilage (a plate of soft tissue). The cartilage is absorbed by layers of bone tissue, which increases the length of the bone. this all happens before puberty and the plates close when you hit puberty.. so basically Acromegaly, occurs when the growth plates remain open after puberty (this means that excessive growth occurs during adulthood).. when gigantism occurs before the bone’s growth plates close (in childhood) ... i hope this helps =D
Question: acromegaly and gigantism: in a nut shell...? physiological cause?
social strategies/behavioral recommendations for patients and families?
Answer: both are caused by exess growth hormone. If this excess is during child hood then you get gigantism. If it happens after growth plates have fused you get acromegaly.
http://www.emedicine.com/med/topic27.htm
http://www.nlm.nih.gov/medlineplus/ency/article/001174.htm
Question: Can the bony symptoms of acromegaly regress over time with? treatment? If not then can it be cured by surgery? Can some type of surgery reduce the overgrown bone masses in the facial bone structure?
Answer: From my understanding, the growth is stimulated by brain chemistry...
which tells me NO - it will not "regress" over time (on it's own)
and No, surgery on the "bone masses" themselves will help.
However...maybe there's a chemical that will offset what the pituitary sends out...
so yes, there may be a treatment that stops the rapid growth.
Question: Which of these secrets hormone directly responsible for acromegaly? Which of these secrets hormone directly responsible for acromegaly?
a. Testis
b. Ovaries
c. Pancreas
d. Adrenal Gland
e. Thyroid Gland
f. Thymus
g. Pituitary Gland
h. Hypothalamus
i. Pineal Gland
Answer: pituitary gland..but in response to the first answer its too little growth hormone ..too much is gigantism
Question: acromegaly has effect on heart beats and blood preassure ?
Answer: Acromegaly (from Greek akros "extreme" or "extremities" and megas "large" - extremities enlargement) is a hormonal disorder that results when the pituitary gland produces excess growth hormone (hGH). Most commonly it is a benign hGH producing tumor derived from a distinct type of cells (somatotrophs) and called pituitary adenoma.
Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious onset and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years.
Symptoms
Features that result from high level of hGH or expanding tumor include:
Soft tissue swelling of the hands and feet
Brow and lower jaw protrusion
Enlarging hands
Enlarging feet
Arthritis and carpal tunnel syndrome
Teeth spacing increase
Macroglossia [enlarged tongue]
Heart failure
Compression of the optic chiasm leading to loss of vision in the outer visual fields
Diabetes mellitus
Hypertension
Increased palmar sweating and sebum production over the face (seborrhea) are clinical indicators of active growth hormone (GH) producing pituitary tumours. These symptoms can also be used to monitor the activity of the tumour after surgery although biochemical monitoring is confirmatory.
[edit] Causes
[edit] Pituitary adenoma
In over 90 percent of acromegaly patients, the overproduction of GH is caused by a benign tumor of the pituitary gland, called an adenoma. These tumors produce excess GH and, as they expand, compress surrounding brain tissues, such as the optic nerves. This expansion causes the headaches and visual disturbances that are often symptoms of acromegaly. In addition, compression of the surrounding normal pituitary tissue can alter production of other hormones, leading to changes in menstruation and breast discharge in women and impotence in men because of reduced testosterone production.
There is a marked variation in rates of GH production and the aggressiveness of the tumor. Some adenomas grow slowly and symptoms of GH excess are often not noticed for many years. Other adenomas grow rapidly and invade surrounding brain areas or the sinuses, which are located near the pituitary. In general, younger patients tend to have more aggressive tumors.
Most pituitary tumors arise spontaneously and are not genetically inherited. Many pituitary tumors arise from a genetic alteration in a single pituitary cell which leads to increased cell division and tumor formation. This genetic change, or mutation, is not present at birth, but is acquired during life. The mutation occurs in a gene that regulates the transmission of chemical signals within pituitary cells; it permanently switches on the signal that tells the cell to divide and secrete GH. The events within the cell that cause disordered pituitary cell growth and GH oversecretion currently are the subject of intensive research.
[edit] Other tumors
In a few patients, acromegaly is caused not by pituitary tumors but by tumors of the pancreas, lungs, and adrenal glands. These tumors also lead to an excess of GH, either because they produce GH themselves or, more frequently, because they produce GHRH, the hormone that stimulates the pituitary to make GH. In these patients, the excess GHRH can be measured in the blood and establishes that the cause of the acromegaly is not due to a pituitary defect. When these non-pituitary tumors are surgically removed, GH levels fall and the symptoms of acromegaly improve.
In patients with GHRH-producing, non-pituitary tumors, the pituitary still may be enlarged and may be mistaken for a tumor. Therefore, it is important that physicians carefully analyze all "pituitary tumors" removed from patients with acromegaly in order not to overlook the possibility that a tumor elsewhere in the body is causing the disorder.
[edit] Diagnosis
If acromegaly is suspected, medical imaging and medical laboratory investigations are generally used together to confirm or rule out the presence of this condition.
[edit] Hormonal
IGF1 provides the most sensitive and useful lab test for the diagnosis of acromegaly. A single value of the Growth hormone (GH) is not useful in view of its pulsatality (levels in the blood vary greatly even in healthy individuals). GH levels taken 2 hours after a 75 gram glucose tolerance test are helpful in the diagnosis: GH levels are suppressed below 1 μg/L in normal people, and levels higher than this cutoff are confirmatory of acromegaly.
Other pituitary hormones have to be assessed to address the secretory effects of the tumour as well as the mass effect of the tumor on the normal pituitary gland. They include TSH (thyroid stimulating hormone), gonadotropic hormones (FSH,LH), ACTH (adrenocorticotropic hormone), prolactin.
[edit] Radiological
An MRI of the brain focussing on the sella turcica after gadolinium administration allows for clear delineation of the pituitary and the hypothalamus and the location of the tumour.
[edit] Treatment
The goals of treatment are to reduce GH production to normal levels, to relieve the pressure that the growing pituitary tumor exerts on the surrounding brain areas, to preserve normal pituitary function, and to reverse or ameliorate the symptoms of acromegaly. Currently, treatment options include surgical removal of the tumor, drug therapy, and radiation therapy of the pituitary.
[edit] Surgery
Surgery is a rapid and effective treatment, of which there are two alternative methods. The first method, a procedure known as transsphenoidal surgery, involves the surgeon reaching the pituitary through an incision in the nose and, with special tools, removing the tumor tissue. The second method is the removal of the tumor via a craniotomy, during which a bone flap is removed from the patient's skull to allow access to the tumor from the front and side. Once the tumor has been removed, the section of bone is replaced. Transsphenoidal surgery is a less invasive procedure with a shorter recovery time than a craniotomy, yet the likelihood of successfully removing the entire tumor is lower. Consequently, transsphenoidal surgery is often used as a first option, with craniotomy and other treatments being used to remove any remaining tumor.
These procedures promptly relieve the pressure on the surrounding brain regions and lead to a lowering of GH levels. If the surgery is successful, facial appearance and soft tissue swelling improve within a few days. Surgery is most successful in patients with blood GH levels below 40 ng/ml before the operation and with pituitary tumors no larger than 10 mm in diameter. Success depends on the skill and experience of the surgeon. The success rate also depends on what level of GH is defined as a cure. The best measure of surgical success is normalization of GH and IGF-1 levels. Ideally, GH should be less than 2 ng/ml after an oral glucose load. A review of GH levels in 1,360 patients worldwide immediately after surgery revealed that 60 percent had random GH levels below 5 ng/ml. Complications of surgery may include cerebrospinal fluid leaks, meningitis, or damage to the surrounding normal pituitary tissue, requiring lifelong pituitary hormone replacement.
Even when surgery is successful and hormone levels return to normal, patients must be carefully monitored for years for possible recurrence. More commonly, hormone levels may improve, but not return completely to normal. These patients may then require additional treatment, usually with medications.
[edit] Drug therapy
Two medications currently are used to treat acromegaly. These drugs reduce both GH secretion and tumor size. Medical therapy is sometimes used to shrink large tumors before surgery. Bromocriptine (Parlodel) in divided doses of about 20 mg daily reduces GH secretion from some pituitary tumors. Side effects include gastrointestinal upset, nausea, vomiting, light-headedness when standing, and nasal congestion. These side effects can be reduced or eliminated if medication is started at a very low dose at bedtime, taken with food, and gradually increased to the full therapeutic dose. Because bromocriptine can be taken orally, it is an attractive choice as primary drug or in combination with other treatments. However, bromocriptine lowers GH and IGF-1 levels and reduces tumor size in less than half of patients with acromegaly. Some patients report improvement in their symptoms although their GH and IGF-1 levels still are elevated.
The second medication used to treat acromegaly is octreotide (Sandostatin) and lanreotide (Somatulin). Both are synthetic forms of a brain hormone, somatostatin, that stops GH production. The long-acting forms of these drugs must be injected every 2 to 4 weeks for effective treatment. Most patients with acromegaly respond to this medication. In many patients, GH levels fall within one hour and headaches improve within minutes after the injection. Several studies have shown that octreotide and lanreotide are effective for long-term treatment. Octreotide and lanreotide have also been used successfully to treat patients with acromegaly caused by non-pituitary tumors.
Because octreotide inhibits gastrointestinal and pancreatic function, long-term use causes digestive problems such as loose stools, nausea, and gas in one third of patients. In addition, approximately 25 percent of patients develop gallstones, which are usually asymptomatic. In rare cases, octreotide treatment can cause diabetes. On the other hand, scientists have found that in some acromegaly patients who already have diabetes, octreotide can reduce the need for insulin and improve blood sugar control.
The latest development in the medical treatment of acromegaly is the use of growth hormone receptor antagonists. The only available member of this family is pegvisomant (Somavert). By blocking the action of the endogenous growth hormone molecules, this compound is able to control disease activity of acromegaly in virtually all patients. Pegvisomant has to be administered subcutaneously by daily injections. Combinations of long-acting somatostatin analogues and weekly injections of pegvisomant seem to be equally effective as daily injections of pegvisomant.
[edit] Radiation therapy
Radiation therapy has been used both as a primary treatment and combined with surgery or drugs. It is usually reserved for patients who have tumor remaining after surgery. These patients often also receive medication to lower GH levels. Radiation therapy is given in divided doses over four to six weeks. This treatment lowers GH levels by about 50 percent over 2 to 5 years. Patients monitored for more than 5 years show significant further improvement. Radiation therapy causes a gradual loss of production of other pituitary hormones with time. Loss of vision and brain injury, which have been reported, are very rare complications of radiation treatments.
No single treatment is effective for all patients. Treatment should be individualized depending on patient characteristics, such as age and tumor size. If the tumor has not yet invaded surrounding brain tissues, removal of the pituitary adenoma by an experienced neurosurgeon is usually the first choice. After surgery, a patient must be monitored for a long time for increasing GH levels. If surgery does not normalize hormone levels or a relapse occurs, a doctor will usually begin additional drug therapy. The first choice should be bromocriptine because it is easy to administer; octreotide is the second alternative. With both medications, long-term therapy is necessary because their withdrawal can lead to rising GH levels and tumor re-expansion. Radiation therapy is generally used for patients whose tumors are not completely removed by surgery; for patients who are not good candidates for surgery because of other health problems; and for patients who do not respond adequately to surgery and medication.
[edit] Pituitary gigantism in children
This condition of growth hormone excess is rare in children and is referred to as pituitary gigantism, because the excessive growth hormone produces excessive growth of bones and the child can achieve excessive height. As an affected child becomes an adult, many of the adult problems can gradually develop. The distinction between gigantism (occurring in children) and acromegaly (occurring in adults) can be made by the occurrence of the adenoma in relation to the closure of the epiphyses. If elevated growth hormone levels occur before the closure of the epiphyses (i.e. in prepubertal children), then gigantism ensues. If it occurs after the closure of the epiphyses (i.e., in adults) then acromegaly ensues.
[edit] Notable sufferers
Famous patients, all standing in excess of 2.00 metres:
Actor Richard Kiel ('Jaws' in the James Bond movies), 7'2" tall
Actor Carel Struycken (known e.g as Lurch in the Addams Family -movies, and for his other giant roles), 7' tall
Actor Matthew McGrory (listed in the Guinness Book of World Records for having the largest feet - size 29 1/2), 7'6" tall (died at the age of 32)
Actor Rondo Hatton
Wrestler and actor André the Giant, 6'9" tall after he had a back surgery that made him a couple inches shorter than he originially was, which was closer to 7 feet tall. He died at the age of 46, when most sufferers weren't expected to live past the age of 40. (chose not to be treated and died from disease)
Wrestler Paul Wight (The Big Show), had surgery on his pituitary gland in the 1990s to fix the condition, his height peaking at 6'11 1/2" tall
Former NBA player Gheorghe MureÅŸan (star of My Giant), 7'7" tall
Aspiring basketball player Sun Ming Ming, 7'9" tall
Makeup artist Kevyn Aucoin
It has been suggested that the character 'Punch' from Punch and Judy was originally a caricature of an Acromegaly sufferer.[1]
Question: About acromegaly,I AM SO STUCKED,help? I AM SO STUCKED,my paper deadline is 10.18
this question is very difficult,but some of you must be experts,I know, my friends,2 questions
how many hgh(IU)does acromegaly sufferer excreted every day?
how long does it take for a guy to be a acromegaly sufferer?
Answer: Acromegaly (from Greek akros "high" and megas "large" - extremities enlargement) is a hormonal disorder that results when the pituitary gland produces excess growth hormone (hGH). Most commonly it is a benign hGH producing tumor derived from a distinct type of cells (somatotrophs) and called pituitary adenoma.
Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious onset and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years.
Contents
1 Symptoms
2 Causes
2.1 Pituitary adenoma
2.2 Other tumors
3 Diagnosis
3.1 Hormonal
3.2 Radiological
4 Treatment
4.1 Surgery
4.2 Drug therapy
4.3 Radiation therapy
5 Pituitary gigantism in children
6 Notable sufferers
7 See also
8 External links
Symptoms
Features that result from high level of hGH or expanding tumor include:
Soft tissue swelling of the hands and feet
Brow and lower jaw protrusion
Enlarging hands
Enlarging feet
Arthritis and carpal tunnel syndrome
Teeth spacing increase
Heart failure
Compression of the optic chiasm leading to loss of vision in the outer visual fields
Diabetes mellitus
Hypertension
Increased palmar sweating and sebum production over the face (seborrhea) are clinical indicators of active growth hormone (GH) producing pituitary tumours. These symptoms can also be used to monitor the activity of the tumour after surgery although biochemical monitoring is confirmatory.
Causes
Pituitary adenoma
In over 90 percent of acromegaly patients, the overproduction of GH is caused by a benign tumor of the pituitary gland, called an adenoma. These tumors produce excess GH and, as they expand, compress surrounding brain tissues, such as the optic nerves. This expansion causes the headaches and visual disturbances that are often symptoms of acromegaly. In addition, compression of the surrounding normal pituitary tissue can alter production of other hormones, leading to changes in menstruation and breast discharge in women and impotence in men.
There is a marked variation in rates of GH production and the aggressiveness of the tumor. Some adenomas grow slowly and symptoms of GH excess are often not noticed for many years. Other adenomas grow rapidly and invade surrounding brain areas or the sinuses, which are located near the pituitary. In general, younger patients tend to have more aggressive tumors.
Most pituitary tumors arise spontaneously and are not genetically inherited. Many pituitary tumors arise from a genetic alteration in a single pituitary cell which leads to increased cell division and tumor formation. This genetic change, or mutation, is not present at birth, but is acquired during life. The mutation occurs in a gene that regulates the transmission of chemical signals within pituitary cells; it permanently switches on the signal that tells the cell to divide and secrete GH. The events within the cell that cause disordered pituitary cell growth and GH oversecretion currently are the subject of intensive research.
Other tumors
In a few patients, acromegaly is caused not by pituitary tumors but by tumors of the pancreas, lungs, and adrenal glands. These tumors also lead to an excess of GH, either because they produce GH themselves or, more frequently, because they produce GHRH, the hormone that stimulates the pituitary to make GH. In these patients, the excess GHRH can be measured in the blood and establishes that the cause of the acromegaly is not due to a pituitary defect. When these non-pituitary tumors are surgically removed, GH levels fall and the symptoms of acromegaly improve.
In patients with GHRH-producing, non-pituitary tumors, the pituitary still may be enlarged and may be mistaken for a tumor. Therefore, it is important that physicians carefully analyze all "pituitary tumors" removed from patients with acromegaly in order not to overlook the possibility that a tumor elsewhere in the body is causing the disorder.
Diagnosis
If acromegaly is suspected, medical imaging and medical laboratory investigations are generally used together to confirm or rule out the presence of this condition.
Hormonal
IGF1 provides the most sensitive and useful lab test for the diagnosis of acromegaly. A single value of the Growth hormone (GH) is not useful in view of its pulsatality (levels in the blood vary greatly even in healthy individuals). GH levels taken 2 hours after a 75 gram glucose tolerance test are helpful in the diagnosis: GH levels are suppressed below 1 μg/L in normal people, and levels higher than this cutoff are confirmatory of acromegaly.
Other pituitary hormones have to be assessed to address the secretory effects of the tumour as well as the mass effect of the tumor on the normal pituitary gland. They include TSH (thyroid stimulating hormone), gonadotropic hormones (FSH,LH), ACTH (adrenocorticotropic hormone), prolactin.
Radiological
A MRI of the brain focussing on the sella after gadolinium administration allows for clear delineation of the pituitary and the hypothalamus and the location of the tumour.
Treatment
The goals of treatment are to reduce GH production to normal levels, to relieve the pressure that the growing pituitary tumor exerts on the surrounding brain areas, to preserve normal pituitary function, and to reverse or ameliorate the symptoms of acromegaly. Currently, treatment options include surgical removal of the tumor, drug therapy, and radiation therapy of the pituitary.
Surgery
Surgery is a rapid and effective treatment. The surgeon reaches the pituitary through an incision in the nose and, with special tools, removes the tumor tissue in a procedure called transsphenoidal surgery. This procedure promptly relieves the pressure on the surrounding brain regions and leads to a lowering of GH levels. If the surgery is successful, facial appearance and soft tissue swelling improve within a few days. Surgery is most successful in patients with blood GH levels below 40 ng/ml before the operation and with pituitary tumors no larger than 10 mm in diameter. Success depends on the skill and experience of the surgeon. The success rate also depends on what level of GH is defined as a cure. The best measure of surgical success is normalization of GH and IGF-1 levels. Ideally, GH should be less than 2 ng/ml after an oral glucose load. A review of GH levels in 1,360 patients worldwide immediately after surgery revealed that 60 percent had random GH levels below 5 ng/ml. Complications of surgery may include cerebrospinal fluid leaks, meningitis, or damage to the surrounding normal pituitary tissue, requiring lifelong pituitary hormone replacement.
Even when surgery is successful and hormone levels return to normal, patients must be carefully monitored for years for possible recurrence. More commonly, hormone levels may improve, but not return completely to normal. These patients may then require additional treatment, usually with medications.
Drug therapy
Two medications currently are used to treat acromegaly. These drugs reduce both GH secretion and tumor size. Medical therapy is sometimes used to shrink large tumors before surgery. Bromocriptine (Parlodel) in divided doses of about 20 mg daily reduces GH secretion from some pituitary tumors. Side effects include gastrointestinal upset, nausea, vomiting, light-headedness when standing, and nasal congestion. These side effects can be reduced or eliminated if medication is started at a very low dose at bedtime, taken with food, and gradually increased to the full therapeutic dose. Because bromocriptine can be taken orally, it is an attractive choice as primary drug or in combination with other treatments. However, bromocriptine lowers GH and IGF-1 levels and reduces tumor size in less than half of patients with acromegaly. Some patients report improvement in their symptoms although their GH and IGF-1 levels still are elevated.
The second medication used to treat acromegaly is octreotide (Sandostatin) and lanreotide (Somatulin). Both are synthetic forms of a brain hormone, somatostatin, that stops GH production. The long-acting forms of these drugs must be injected every 2 to 4 weeks for effective treatment. Most patients with acromegaly respond to this medication. In many patients, GH levels fall within one hour and headaches improve within minutes after the injection. Several studies have shown that octreotide and lanreotide are effective for long-term treatment. Octreotide and lanreotide have also been used successfully to treat patients with acromegaly caused by non-pituitary tumors.
Because octreotide inhibits gastrointestinal and pancreatic function, long-term use causes digestive problems such as loose stools, nausea, and gas in one third of patients. In addition, approximately 25 percent of patients develop gallstones, which are usually asymptomatic. In rare cases, octreotide treatment can cause diabetes. On the other hand, scientists have found that in some acromegaly patients who already have diabetes, octreotide can reduce the need for insulin and improve blood sugar control.
The latest development in the medical treatment of acromegaly is the use of growth hormone receptor antagonists. The only available member of this family is pegvisomant (Somavert). By blocking the action of the endogenous growth hormone molecules, this compound is able to control disease activity of acromegaly in virtually all patients. Pegvisomant has to be administered subcutaneously by daily injections. Combinations of long-acting somatostatin analogues and weekly injections of pegvisomant seem to be equally effective as daily injections of pegvisomant.
Radiation therapy
Radiation therapy has been used both as a primary treatment and combined with surgery or drugs. It is usually reserved for patients who have tumor remaining after surgery. These patients often also receive medication to lower GH levels. Radiation therapy is given in divided doses over four to six weeks. This treatment lowers GH levels by about 50 percent over 2 to 5 years. Patients monitored for more than 5 years show significant further improvement. Radiation therapy causes a gradual loss of production of other pituitary hormones with time. Loss of vision and brain injury, which have been reported, are very rare complications of radiation treatments.
No single treatment is effective for all patients. Treatment should be individualized depending on patient characteristics, such as age and tumor size. If the tumor has not yet invaded surrounding brain tissues, removal of the pituitary adenoma by an experienced neurosurgeon is usually the first choice. After surgery, a patient must be monitored for a long time for increasing GH levels. If surgery does not normalize hormone levels or a relapse occurs, a doctor will usually begin additional drug therapy. The first choice should be bromocriptine because it is easy to administer; octreotide is the second alternative. With both medications, long-term therapy is necessary because their withdrawal can lead to rising GH levels and tumor re-expansion. Radiation therapy is generally used for patients whose tumors are not completely removed by surgery; for patients who are not good candidates for surgery because of other health problems; and for patients who do not respond adequately to surgery and medication.
Pituitary gigantism in children
This condition of growth hormone excess is rare in children and is referred to as pituitary gigantism, because the excessive growth hormone produces excessive growth of bones and the child can achieve excessive height. As an affected child becomes an adult, many of the adult problems can gradually develop. The distinction between gigantism (occurring in children) and acromegaly (occurring in adults) can be made by the occurrence of the adenoma in relation to the closure of the epiphyses. If elevated growth hormone levels occur before the closure of the epiphyses (i.e. in prepubertal children), then gigantism ensues. If it occurs after the closure of the epiphyses (i.e., in adults) then acromegaly ensues.
Notable sufferers
Famous patients, all standing in excess of 2.00 metres:
Actor Richard Kiel ('Jaws' in the James Bond movies), 7'2" tall
Actor Carel Struycken (known e.g as Lurch in the Addams Family -movies, and for his other giant roles), 7' tall
Actor Matthew McGrory, 7'6" tall
Wrestler André the Giant, 6'10"
Wrestler Paul Wight (The Big Show), had surgery on his pituitary gland in the 1990s to fix the condition, his height peaking at 7'1" (2.16 m) tall.
It has been suggested that the character 'Punch' from Punch and Judy was originally a caricature of an Acromegaly sufferer.
Question: When the pituitary gland produces too much growth hormone in an adult, what condition occurs? Possible answers:
A. Neuritis.
B. Hirsutism.
C. Acromegaly.
D. Cretinism.
Answer: c.
http://www.acromegaly.org/
Question: i think i have acromegaly.does treatment hurt im scared of surgery?
Answer: You need to be diagnosed first. Acromegaly is usually due to a pituitary tumor, and can be treated with drugs, surgery or a new radiation treatment called Gamma Knife. None of these should involve much if any pain.
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