What are Gigantism and Acromegaly?

 

Acromegaly and Gigantism are diseases of growth hormone hypersecretion. The Pituitary adenoma is the primary cause of gigantism and acromegaly [1].

 

If growth hormone hypersecretion occurs before the closure of long bone epiphysis, it is known as gigantism. Gigantism is characterized by tall stature.

 

Acromegaly occurs when growth hormone hypersecretion occurs after the closure of epiphysis. It leads to large extremities and characteristic facies. Acromegaly occurs in adulthood while gigantic occurs in childhood [2].

 

About 95% of acromegaly and gigantic cases are secondary to growth hormone-secreting pituitary adenoma. The first line of treatment is surgical excision. If left untreated, acromegaly and gigantism can lead to major health problems.

 

 

 

What are the Symptoms of Gigantism and Acromegaly?

 

 

The signs and symptoms of gigantism are as follows [3]:

• Large height
• Obesity (mild to moderate)
• Macrocephaly
• Headaches
• Eyesight issues
• Hypertrophy of soft tissues
• Exaggerated growth of hands and feet
• Thick fingers and toes
• Frontal bossing
• Coarse facial features
• Abnormal projection of the jaw
• Hyperhidrosis
• Osteoarthritis
• Carpal Tunnel Syndrome
• Cardiovascular diseases

 

The manifestation of acromegaly is as follows:

• Rough skin over the face and extremities
• Thick nails
• Large pores
• Thick eyelids
• The wide spacing of teeth
• Proganthism
• Oily skin (acne is not common)
• Cutis Verticis Gyrata (i.e.: furrows resembling gyri of the scalp)
• Small sessile and pedunculated fibroma
• Hyperpigmentation
• Great tissue becoming atrophic
• High blood pressure
• Mild hirsutism (in women)
• Hypertrichosis
• Excessive eccrine and apocrine sweating
• Breast tissue atrophy
• galactorrhea
• Mitral valvular regurgitation

 

 

 

What are the Causes of Gigantism and Acromegaly?

 

Both acromegaly and gigantism are caused by pituitary tumors. The other genetic conditions that cause gigantism include Carney complex, McCune-Albright syndrome, Multiple endocrine neoplasia (type I or IV), neurofibromatosis, and GPR101 gene mutation [4].

 

Acromegaly is primarily caused by pituitary tumors. The other causes of acromegaly are lung tumors, pancreatic tumors, hypothalamus tumors, adrenal gland tumors, chest tumors, and abdominal tumors.

 

 

 

What are the Treatment Options for Gigantism and Acromegaly?

 

The treatment options vary depending on the location and size of the tumor, the severity of symptoms, your age, and your health. The treatment aims to reduce your Growth hormone level to normal. [5]

 

The treatment options include:

 

• Surgery: Pituitary tumors are removed by endoscopic transnasal transsphenoidal surgery (TSS). If tumors are not completely removed, another surgery or radiotherapy may be recommended.

 

• Medications: The doctor can recommend drugs that reduce growth hormone production (somatostatin analogs), drugs to lower hormone levels (dopamine agonists), and drugs to block the action of growth hormone (growth hormone antagonist).

 

• Radiotherapy

 

 

 

 

 

References:

1. https://www.ncbi.nlm.nih.gov/books/NBK538261/
2. https://www.mayoclinic.org/diseases-conditions/acromegaly/symptoms-causes/syc-20351222
3. https://emedicine.medscape.com/article/925446-clinical
4. https://www.medicinenet.com/difference_between_acromegaly_and_gigantism/article.htm
5. https://www.mayoclinic.org/diseases-conditions/acromegaly/diagnosis-treatment/drc-20351226

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