Acromegaly is a rare hormonal disorder that results from an excess of growth hormone (GH) in the body. It's most often diagnosed in middle-aged adults, and its progression is typically slow. Here's an overview:

Causes

  1. Pituitary Adenomas: The most common cause of acromegaly is a benign tumor on the pituitary gland, known as a pituitary adenoma. These tumors produce excess growth hormone.

  2. Non-Pituitary Tumors: In rare cases, tumors in other parts of the body, such as the lungs or pancreas, can cause acromegaly by producing growth hormone-releasing hormone (GHRH), which stimulates the pituitary gland.

Signs and Symptoms

  • Enlarged Hands and Feet: One of the most noticeable signs is an increase in the size of the hands and feet.

  • Facial Changes: Enlarged facial features, including a protruding lower jaw and brow, an enlarged nose, and thicker lips.

  • Skin Changes: Thick, oily skin, and sometimes skin tags.

  • Joint Pain: Can lead to arthritis and carpal tunnel syndrome.

  • Vision Problems: Caused by the tumor pressing on the optic nerves.

  • Sleep Apnea: Due to airway obstruction.

  • Enlarged Organs: Such as the heart, which can lead to cardiovascular problems.

Treatment

Treatment aims to reduce growth hormone production to normal levels, relieve pressure the tumor may be exerting on surrounding tissues, and improve symptoms.

  1. Surgery: The primary treatment is surgical removal of the tumor. If the tumor is completely removed, this can immediately reduce hormone levels and relieve symptoms.

  2. Medications:
    • Somatostatin Analogs: Drugs like octreotide and lanreotide can reduce growth hormone secretion.

    • Growth Hormone Receptor Antagonists: Pegvisomant blocks the effect of growth hormone on the body.

    • Dopamine Agonists: Such as cabergoline, can reduce growth hormone release in some patients.

  3. Radiation Therapy: Used when surgery can't remove the entire tumor or if the patient cannot undergo surgery. It gradually reduces growth hormone levels over time.

Medications

  • Octreotide and Lanreotide: Somatostatin analogs that inhibit growth hormone release.

  • Pegvisomant: Blocks the effects of growth hormone on tissues.

  • Cabergoline: A dopamine agonist that can sometimes reduce growth hormone levels.

Regular monitoring and follow-up are important in managing acromegaly. It's also crucial to address any comorbid conditions, such as diabetes or hypertension, that may arise as a result of the disorder. The treatment approach often involves a team of specialists, including endocrinologists, neurosurgeons, and radiation oncologists.