Acromegaly

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What is Acromegaly?

Acromegaly is a chronic metabolic disorder caused by the presence of too much growth hormone - GH and IGF-I hypersecretion. Growth hormone is a hormone secreted by the pituitary gland in response to GHRH secretion from the hypothalamus, and in excess it results in gradual enlargement of body tissues including the bones of the face, jaw, hands, feet, and skull.

Who gets Acromegaly?

Incidence is 5.3 per 100000 per year.

Males and females are affected equally

Highest incidence in middle age (4th and 5th decades).

It is estimated that six years elapse between the onset of symptoms and the diagnosis.

Predisposing Factors

The cause is usually a benign pituitary tumour (pituitary adenoma). Hyperplasia from excessive GHRH secretion from the hypothalamus is the other main cause but that is rare. There are no known risk factors for acromegaly other than a prior history of a pituitary tumor.

Progression

The life expectancy of a patient with untreated acromegaly is 50 years, most due to a hypertrophic cardiomyopathy and malignant ventricular arrhythmias. Osteoporosis and fractures are frequent complications. Although glucose intolerance is common very few develop ketoacidosis or other significant complications of diabetes mellitus.

The tumour may compromise visual fields. When it is adequately treated, life expectancy returns to normal and the other complications remit.

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