Acromegaly

Acromegaly is a disease that appears when the adult body has an excess of growth hormone. This condition causes excessive growth in a number of organs, as well as muscle and bone tissue, especially in the legs, hands, and face.

Increased growth hormone production is generally caused by benign tumors in the pituitary gland. Increases can also be caused by tumors in other organs, such as the lungs or pancreas, but this is rare.

Although it can occur at any age, acromegaly usually occurs in people aged 30-50 years. If it happens to a child, excess 
growth hormone does not cause acromegaly but 
gigantism.

causes Acromegaly

Acromegaly occurs due to high production of growth hormone (GH) and is one of the symptoms of hyperpituitarism. In adulthood, an increase in growth hormone is usually caused by the presence of a growing tumor.

There are two types of tumors that can increase GH production, namely:

Pituitary tumor

In most cases, acromegaly is caused by a tumor in the pituitary gland. This gland is located at the bottom of the brain and functions to produce various important hormones for the body, one of which is growth hormone .

GH triggers the liver to produce insulin-like growth factor I (IGF-I) which functions as a bone and tissue growth stimulant. Excessive GH levels will affect the production of IGF-I. As a result, abnormal growth occurs in organs and muscle and bone tissue.

Nonpituitary tumors

Tumors that appear in other parts of the body, such as the lungs, pancreas, and brain, can also increase GH production. In some other cases, the tumor can also produce growth hormone-releasing hormone (GHRH) or a hormone that releases growth hormone so that GH production increases.

GH can also increase when the hypothalamus is disrupted so that it cannot control the cells that produce GH. The hypothalamus is a part of the brain that also produces several hormones that are important for the body.

Symptoms and Signs of Acromegaly

Acromegaly does not always show symptoms in its sufferers. However, the symptoms and signs of acromegaly will become more apparent with age. Complaints experienced by each sufferer can also be different, among others:

Signs of acromegaly:

• Legs and hands grow
• Facial structure changes
• The size of the tongue, nose, and lips increases
• Crooked teeth
• Oily and rough skin
• Loud snoring while sleeping
• The chest cavity becomes wide (barrel chest).
• Hoarse and heavy voice (due to enlargement of the vocal cords and sinuses)
• The heart is enlarged

Symptoms of acromegaly:

• Excessive sweat, even body odor
• Headache
• Fatigue and the body feels weak
• Muscles weaken
• Joint pain and limited mobility
• Visual impairment
• Difficulty sleeping
• Menstrual cycle disorders in women
• Loss of sex drive
• Erectile dysfunction in men

When should you go to the doctor?

Acromegaly tends to develop slowly so that early symptoms and signs may not be visible. In fact, the symptoms and signs of this condition can only appear after several years.

If you have detected the symptoms and signs of acromegaly, immediately see a doctor or visit the nearest hospital to get early treatment.

Meanwhile, for those of you who have been diagnosed with acromegaly, do routine check-ups with your doctor to monitor the progress of the disease, evaluate treatment, and prevent recurrence of the disease.

Diagnosis of Acromegaly

In diagnosing acromegaly, the doctor will first check the patient’s symptoms and health history, then continue with a physical examination. After that, some further examinations below will be done to confirm the diagnosis:

• Blood tests Blood
  tests are performed by measuring GH and IGF-I levels. The purpose is to find out how many hormones are produced.
• CT scans and MRI scans
  CT scans and MRI scans are used to find out the location and size of tumors on the pituitary gland or enlarged body organs. In addition, the doctor can also do an X-ray to check the density and size of the bones.

Acromegaly treatment

The type of treatment for acromegaly depends on the cause. The purpose of treatment is to reduce the severity of symptoms, regulate excess growth hormone levels, and overcome disorders in the pituitary gland.

The following are three treatment methods that can be used by doctors to overcome acromegaly:

Medicines

The following drugs are used as supportive treatment after surgery, or if surgery cannot be performed:

• Dopamine agonist
  This drug works to suppress the production of GH and IGH-I. An example of this drug is bromocriptine .
• Somatostatin analogues
  Medicines such as octreotide are used to control the production and flow of growth hormones, as well as shrink the size of tumors.
• Growth hormone antagonist
  This drug works to block the effects of growth hormone on body tissue. One example of this drug is pegvisomant.

Operation

Surgical procedures are generally recommended to remove tumors from the pituitary gland that are pressing on nerves and triggering excess GH production. The operation performed aims to remove the tumor using endoscopic techniques .

Radiotherapy

Radiotherapy is recommended if the tumor cannot be completely removed by surgical procedures. This therapy aims to destroy the remaining tumor cells and suppress growth hormone levels slowly.

Complications of Acromegaly

Untreated acromegaly can lead to complications, such as:

• Carpal tunnel syndrome
• Sleep apnea , which can close the airways
• Osteoarthritis or arthritis
• Miscarriage in pregnant women
• Hypertension
• Diabetes
• Thyroid disease
• Heart disease, especially cardiomyopathy
• Hypopituitarism
• Polyp growth in the colon
• Benign tumor growth in the uterus
• Pressure on the spinal nerves
• Blindness

Prevention of acromegaly

Acromegaly cannot be prevented. However, if you are diagnosed with this disease, early treatment can prevent the worsening of acromegaly and prevent complications.

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