Acromegaly

 

Alternative Names

Somatotroph adenoma; Growth hormone excess; Pituitary giant (in childhood)

Definition

Acromegaly is a condition in which there is too much growth hormone in the body.

Causes

Acromegaly is a rare condition. It is caused when the pituitary gland makes too much growth hormone. The pituitary gland is a pea-sized endocrine gland located at the base of the brain. It controls, makes, and releases several hormones, including growth hormone.

Usually a noncancerous (benign) tumor of the pituitary gland causes the gland to release too much growth hormone.

In children, too much growth hormone causes gigantism rather than acromegaly.

Symptoms

Symptoms of acromegaly may include any of the following:

  • Body odor
  • Carpal tunnel syndrome
  • Decreased muscle strength (weakness)
  • Decreased peripheral vision
  • Easy fatigue
  • Excessive height (when excess growth hormone production begins in childhood)
  • Excessive sweating
  • Headache
  • Hoarseness
  • Joint pain, limited joint movement, swelling of the bony areas around a joint
  • Large bones of the face
  • Large feet (change in shoe size), large hands (change in ring or glove size)
  • Large glands in the skin (sebaceous glands)
  • Large jaw (prognathism) and tongue (macroglossia)
  • Sleep apnea
  • Thickening of the skin, skin tags
  • Widely spaced teeth
  • Widened fingers or toes, with swelling, redness, and pain

Other symptoms that may occur with this disease:

Exams and Tests

The health care provider will perform a physical exam and ask about your symptoms.

The following tests may be ordered to confirm diagnosis of acromegaly:

Treatment

Surgery to remove the pituitary tumor that is causing this condition often corrects the abnormal growth hormone. Sometimes the tumor is too large to remove completely. People who do not respond to surgery may have radiation of the pituitary gland.

Medications are used after surgery. Some patients are treated with medicines instead of surgery.

After treatment, you will need to see your health care provider regularly to make sure that the pituitary gland is working normally. Yearly evaluations are recommended.

Outlook (Prognosis)

Pituitary surgery is successful in most patients, depending on the size of the tumor and the experience of the surgeon.

Without treatment, the symptoms will get worse. Conditions such as high blood pressure, diabetes, and heart disease may result.

When to Contact a Medical Professional

Call your health care provider if:

  • You have symptoms of acromegaly
  • Your symptoms do not improve with treatment

Prevention

Acromegaly cannot be prevented. Early treatment may prevent complications of the disease from getting worse.

References

Katznelson L, Atkinson JLD, Cook DM, et al. American Association of Clinical Endocrinologists medical guidelines for clinical practice for the diagnosis and treatment of acromegaly - 2011 update. Endocr Pract. 2011;17(Suppl 4):1-44.

Melmed S, Kleinberg D. Pituitary masses and tumors. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Textbook of Endocrinology. 12th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 9.

Review Date: 11/7/2013
Reviewed By: Brent Wisse, MD, Associate Professor of Medicine, Division of Metabolism, Endocrinology & Nutrition, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

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