Understanding Gigantism and Acromegaly: A Modern Family Doctor's Perspective
Overview
Gigantism and acromegaly are two rare conditions caused by the excessive secretion of growth hormone (GH) at different stages of life. This article, adapted from Chinese medical guidance, provides an overview of these conditions, their diagnosis, and treatment options.
The Basics of Gigantism and Acromegaly
Gigantism
Gigantism occurs when the body produces too much growth hormone before the growth plates in the long bones close. This condition is often diagnosed in children and adolescents, leading to a significantly taller stature than their peers. The onset of gigantism is typically in early childhood, with the individual continuing to grow until the growth plates close and the growth hormone levels normalize.
Acromegaly
Acromegaly, on the other hand, happens when there is an excess of growth hormone after the growth plates have closed, usually in adulthood. It is characterized by the gradual enlargement of the hands, feet, and facial features, as well as other symptoms. The incidence of acromegaly is approximately 3 in every 100,000 people per year, with a similar prevalence in both males and females, most commonly occurring between the ages of 31 and 50.
Diagnosis
Symptoms
The symptoms of gigantism and acromegaly can vary widely, but common signs include:
- Reduced tolerance for sugar
- Diabetes
- Cardiovascular disease
- Fatigue
- Hair loss
- Reduced libido
- Enlarged organs
- Joint pain and stiffness
- Excessive sweating
- Changes in skin color and texture
- Muscle weakness
- Insulin resistance
Laboratory Tests
Diagnosis typically involves blood tests to measure GH levels, as well as imaging studies such as MRI or CT scans of the brain to identify any abnormalities in the pituitary gland.
Treatment
Surgical Treatment
Surgery is often the first-line treatment for gigantism and acromegaly. Microsurgical removal of the tumor can be highly effective, with a cure rate of up to 90% for small tumors. However, the success rate may be lower for larger tumors that have extended beyond the sella turcica.
Radiotherapy
Radiotherapy can be used before or after surgery to destroy the tumor. The effectiveness of radiotherapy is often seen over a longer period, typically 2 to 10 years.
Medications
Medications such as bromocriptine and octreotide can help reduce GH levels and improve symptoms. These drugs are often used in combination with surgery or radiotherapy.
Conclusion
Gigantism and acromegaly are complex conditions that require a multidisciplinary approach to treatment. Early diagnosis and treatment are crucial for improving quality of life and reducing the risk of complications. If you suspect you or someone you know may have gigantism or acromegaly, it is important to seek medical advice promptly.