3. Acromegaly
Definition
Acromegaly is the abnormal enlargement of limbs and facial features as a result of hypersecretion of growth hormone after maturity. The disease is usually the result of a pituitary tumor.
Incidence
The incidence of acromegaly is estimated to be 3:1,000,000 to 4:1,000,000.
Etiology
More than 95% of growth hormone–releasing hormone (GHRH) independent cases of acromegaly are the result of growth hormone (GH)–secreting pituitary adenoma. These adenomas are either macroadenomas (>1 cm) or microadenomas (<1 cm). Macroadenomas predominate, accounting for more than 80% of the tumors.
Signs and Symptoms
• Arthritis
• Bitemporal hemianopia
• Congestive heart failure
• Enlarged thyroid
• Enlarging extremities
• Facial feature coarsening
• Frontal bossing
• Headaches
• Hypercalciuria
• Hyperhidrosis
• Hyperphosphatemia
• Hypertriglyceridemia
• Increased incidence of CHF
• Increased incidence of colonic polyps
• Increased incidence of glucose intolerance