Table of Contents
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 – initial screening test
- Failure to suppress growth hormone during glucose tolerance test – 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.
Create an account or log in to continue reading.
Which hormones are secreted from the anterior pituitary gland?
Oops! This section is restricted to members.
Create an account or log in to continue reading.
Which hormones are secreted from the posterior pituitary gland?
Oops! This section is restricted to members.
Create an account or log in to continue reading.
Try an acromegaly OSCE station
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
