21.) Acromegaly Flashcards
(13 cards)
What is acromegaly?
Acromegaly is a condition caused by benign pituitary adenomas leading to excess secretion of growth hormone (GH) and insulin-like growth factor 1 (IGF-1).
What are the symptoms of acromegaly in adults?
Symptoms include enlarged hands and feet, coarsened facial features, and pathological growth of internal organs.
Macroglossia ( large tongue )
What is the condition called in children before epiphyseal plate closure?
In children, it is known as gigantism.
What is the pathophysiology of acromegaly?
Overproduction of GH leads to abnormally high serum IGF-1 levels, resulting in overstimulation of cell growth and proliferation.
What are the clinical manifestations of acromegaly?
Clinical manifestations include soft tissue and skeleton overgrowth, coarsening facial features, large hands and feet, organomegaly, arthralgia, hypertrophic cardiomyopathy, enlarged jaw (macrognathia), and colon polyps & colonic malignancy.
What metabolic disturbances are associated with acromegaly?
Metabolic disturbances include glucose intolerance and diabetes mellitus in 10%-25% of patients, as well as hyperhidrosis.
What are the parasellar manifestations of acromegaly?
Parasellar manifestations include headache, visual loss due to optic chiasm compression, cavernous sinus compression, hypertension, and sleep apnea.
How is acromegaly diagnosed?
Diagnosis involves clinical signs, measuring serum IGF-1, performing an oral glucose tolerance test, and measuring growth hormone levels.
What confirms the diagnosis of acromegaly?
If growth hormone is not suppressed 2 hours after glucose ingestion, acromegaly is confirmed.
Normally, when a healthy person drinks glucose, their GH levels drop (because glucose suppresses GH).
• In acromegaly, the pituitary tumor keeps secreting GH, even after glucose intake.
What imaging is performed to confirm acromegaly?
MRI of the pituitary is performed to confirm the mass or to look for extra pituitary causes.
What is the treatment for acromegaly?
Treatment options include transsphenoidal adenectomy, medication, and radiotherapy.
First choice (most effective):
• Octreotide
• Dose: 20–30 mg IM every 4 weeks (long-acting form)
• Class: Somatostatin analog → inhibits GH secretion
What medications are used to treat acromegaly?
Medications include somatostatin analogs (octreotide), dopamine agonists (cabergoline), and GH receptor antagonists (pegvisomant).
What types of radiotherapy are used for acromegaly?
Conventional fractionated radiotherapy and stereotactic radiosurgery (e.g., Gamma Knife, Cyber Knife, proton beam) are used.
