What is Acromegaly?
Acromegaly is a rare disease, a form of giantism, due to disorder of the pituitary gland at the base of the brain. One of the hormones of this gland regulates growth of the body.
If the disease occurs in early life, there is general skeletal over-growth producing giantism. If in later life, there is marked enlargement of the hands, feet, and skull. The lower jaw is especially increased and projects beyond the upper jaw. It is often associated with defects of vision through pressure of the pituitary growth upon the nerves of the eyes. The disease runs a very long course. Occasionally, benefit may be obtained by a surgical operation. Deep X-ray treatment may benefit some cases.
Cause and Characteristics of Acromegaly
The pituitary gland contains several kinds of cells that secrete different hormones. In acromegaly there is an increase in the number of growth hormone secreting cells. This increase in cell number usually produces a pituitary tumor, which may press on the optic nerves and interfere with vision.
The excessive secretion of growth hormone causes many abnormalities. The most obvious changes are in certain soft tissues, cartilage, and bones. These changes give a characteristic burly, large-jawed appearance to patients with the disease.
The skin of the face is puffy, and the facial lines are exaggerated. The nose and ears enlarge; the larynx is big, and the voice is husky. The jawbone lengthens and protrudes forward. Because the rib cartilages lengthen, the chest cage becomes barrel-like. Bony overgrowth in the spine causes difficulty in bending forward and also causes arthritis. Less obvious abnormalities are increased hairiness, sweating, enlargement of the thyroid gland, diabetes, and sometimes high blood pressure.
Acromegaly is usually benign and lasts many years. (Rarely, there is bleeding into the pituitary tumor, which requires quick surgical intervention.) Patients sometimes have bothersome symptoms in various areas: severe headaches; tingling and numbness in hands and feet; back, hip, or knee pain due to arthritis; or severe weakness and wasting of muscles. Except for the change in appearance, most patients tolerate the disease well and are relatively healthy. The major complications are due to diabetes or high blood pressure, when they exist. Occasionally, remaining pituitary tissue is destroyed by the tumor, causing failure of the glands that are dependent upon the pituitary.
X-ray treatment of the pituitary region is the most commonly used method. In most cases, this treatment stops the growth of the tumor and, in some cases, reduces the excessive growth hormone secretion. If visual damage is sudden or great, surgery may be necessary to remove the tumor.
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