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Acromegaly is a rare hormonal disorder that develops when the pituitary gland produces excess growth hormone (GH) after the growth plates in bones have closed, typically in adulthood.
Here are some common types as below:
Diagnosis:
1. Medical History and Physical Examination:
A doctor will look for physical signs (e.g., enlarged hands and feet, facial changes).
The patient’s medical history will be reviewed for gradual onset symptoms.
2. Hormonal Tests:
Insulin-like Growth Factor-1 (IGF-1) Test: Elevated IGF-1 levels indicate excess GH activity because GH stimulates the liver to produce IGF-1.
Oral Glucose Tolerance Test (OGTT): In healthy individuals, GH levels drop after drinking a glucose solution. In acromegaly, GH levels remain high.
3. Imaging Studies:
Magnetic Resonance Imaging (MRI): MRI scans of the pituitary gland can help visualize pituitary tumors (adenomas) and assess their size.
Computed Tomography (CT): In cases where pituitary MRI is negative, CT scans may help detect ectopic tumors.
Treatment:
1. Surgery:
Transsphenoidal Surgery is the primary treatment to remove pituitary adenomas. It is effective in reducing GH levels, especially for smaller tumors.
2. Medications:
Somatostatin analogs (e.g., octreotide, lanreotide): These drugs inhibit GH secretion from the pituitary gland.
GH receptor antagonists (e.g., pegvisomant): Block the action of GH in the body, reducing IGF-1 production.
Dopamine agonists (e.g., cabergoline): These may be used in mild cases or as an adjunct to other treatments.
3. Radiation Therapy:
Stereotactic Radiosurgery: Focused radiation to the pituitary tumor can help reduce GH production, though this treatment works slowly over time and is usually considered when surgery and medications are not fully effective.
4. Monitoring:
Regular follow-up includes testing for GH and IGF-1 levels, as well as MRI scans to monitor tumor regrowth or residual tissue.