Acromegaly

Learn the focussed examination too…

Acromegaly focussed examination covered here!

Acromegaly is a disorder caused by excess growth hormone. Over 99% of cases are due to a growth hormone-secreting pituitary macroadenoma.

Clinical features

Pituitary enlargement symptoms

  • Hypopituitarism
  • Bitemporal hemianopia
  • Headache

Excessive soft tissue growth

  • Increased hand and feet size
  • Coarsening of facial features
  • Prognathism, macrognathia, wide spaces between teeth, macroglossia
  • Hoarse voice
  • Osteoarthritis and arthralgia 
  • Carpal tunnel syndrome

Active acromegaly signs

  • Excessive sweating
  • Hypertension

Investigations

  • Confirm acromegaly
    • Insulin-like growth factor 1 â€“ initial screening test
    • Failure to suppress growth hormone during glucose tolerance test â€“ diagnostic test
  • Pituitary function tests and serum prolactin: to rule out coexistent hypopituitarism
  • MRI pituitary: to visualise tumour

Management

  • Transsphenoidal resection 
  • Second line options
    • Somatostatin analogues (e.g. octreotide)
    • Growth hormone receptor antagonist (e.g. pegvisomant)
    • Radiotherapy 

Try some questions

What are some possible complications of acromegaly?

Oops! This section is restricted to members.

Which hormones are secreted from the anterior pituitary gland?

Oops! This section is restricted to members.

Which hormones are secreted from the posterior pituitary gland?

Oops! This section is restricted to members.

Try an acromegaly OSCE station

  1. Acromegaly focussed exam
  2. There’s lots more focussed examinations to try

Picture references

Face acromegaly photos: 2008 Chanson and Salenave (Acromegaly. Orphanet Journal of Rare Diseases 3:17), licensed under the Creative Commons Attribution 2.0 Generic license

Your email address will not be published. Required fields are marked *

Join our email list!
For free OSCE tips and updates