Acromegaly

Aka: Acromegaly

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II. Pathophysiology

  1. Pituitary Adenoma hypersecretion of Growth Hormone
  2. Occurs after closure of epiphyses

III. Causes

  1. Hyperplastic Pituitary Adenoma
  2. Eosinophilic Pituitary Adenoma

IV. Symptoms

  1. Headache
  2. Vision Loss
  3. Muscular weakness
  4. Back pain
  5. Limb pain
  6. Sweating
  7. Amenorrhea
  8. Polydipsia
  9. Polyuria

V. Signs

  1. Exaggerated supraorbital ridges
  2. Exophthalmos
  3. Enlargement of:
    1. Hands and Feet
    2. Mandible (separation of teeth)
    3. Nose, Lips and Tongue
  4. Bitemporal Hemianopsia to blindness
  5. Weight gain
  6. Hypertension
  7. Cardiomegaly
  8. Hepatomegaly
  9. Hypertrichosis
  10. Hyperthyroidism
    1. Goiter
    2. Thyrotoxicosis
  11. Diabetes Insipidus

VI. Radiology

  1. Overgrowth of cancellous bone
  2. Osteoporosis
  3. Tufted phalangeal tips
  4. Osteoarthritis signs
  5. Enlarged sella turcica

VII. Labs

  1. Elevated plasma Growth Hormone (in active stage)
  2. Increased urinary 17-ketosteroids
  3. High serum inorganic Phosphate
  4. Elevated Alkaline Phosphatase
  5. Hyperglycemia
  6. Glycosuria

VIII. Management

  1. Transphenoidal surgery
  2. Radiation Therapy
  3. Bromocriptine

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