Acromegaly - Symptoms, causes and treatment

Acromegaly or acromegaly is disease that arises because of the body adults excess growth hormonegrowth hormone).This condition causes excessive growth in various organs and tissues muscles and bones, especially in the feet, hands, and face.

Production increase growth hormone usually caused by a benign tumor in the pituitary glandpituitary). The increase 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 occurs in children, excess growth hormone not cause acromegaly but gigantism.

Pecause acromegaly

Acromegaly occurs due to high production of growth hormone (GH). In adulthood, an increase in growth hormone is usually caused by a growing tumor. There are two types of tumors that can increase GH production, namely:

Pituitary tumor

Most cases of acromegaly show a tumor in the pituitary gland that can increase GH production. The pituitary 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 stimulant for bone and tissue growth. Excess GH levels will affect the production of IGF-I, thereby triggering abnormal growth 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.

In addition to tumors, GH can also increase due to disturbances in the hypothalamus 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.

Symptom and Sign Acromegaly

Not all acromegaly conditions show significant symptoms and signs. Symptoms and signs of acromegaly will become more obvious with age. Symptoms and signs that are seen will be different from each patient. Some of the symptoms and signs that can be experienced are:

Signs of acromegaly:

  • Legs and hands enlarged.
  • The facial structure changes.
  • The size of the tongue, nose, and lips is enlarged.
  • There is a gap between the teeth.
  • Oily and rough skin.
  • Snoring loudly while sleeping.
  • The chest cavity becomes wide (barrel chest).
  • Hoarseness and hoarseness (due to widening of the vocal cords and sinuses).
  • The heart is enlarged.

Symptoms of acromegaly:

  • Excessive sweating, to body odor.
  • Headache.
  • Fatigue and body feels l
  • Muscles weaken.
  • Joint pain and limited range of motion.
  • Visual disturbance
  • Hard to sleep.
  • Menstrual cycle disorders in women.
  • Erectile dysfunction in men.
  • Loss of sex drive.

When to go to the doctor

Acromegaly tends to develop slowly so that the initial signs and symptoms may not be visible. Symptoms and signs of acromegaly may appear after several years. If you have detected symptoms and signs of acromegaly, immediately see a doctor or visit the nearest hospital to get early treatment.

If you have been diagnosed with acromegaly, have regular check-ups with your doctor to monitor the progress of the disease, evaluate treatment, and prevent disease recurrence.

Acromegaly Diagnosis

In diagnosing acromegaly, the doctor will first examine the patient's symptoms and medical history. The examination will then be followed by a physical examination. After that, several follow-up examinations below will be carried out to confirm the diagnosis:

  • Tes blood

    This test is done by measuring levels of GH and IGF-I to determine the amount of hormones produced.

  • Scan

    CT scans and MRIs are generally used to determine the location and size of tumors in the pituitary gland or enlarged organs. X-rays can also be done to check bone density and size.  

Acromegaly Treatment

The type of treatment for acromegaly is determined based on the cause. Treatment is focused on reducing the severity of symptoms, regulating excess growth hormone levels, and treating disorders of the pituitary gland.

The following are three treatment methods that doctors can use to treat acromegaly:

Drugs

The following medicines may be used for supportive treatment after surgery, or if surgery cannot be performed:

  • Dopamine agonist

    This drug serves to suppress the production of GH and IGH-I. An example of this drug is bromocriptine.

  • Somatostatin analogues

    Drugs like octreotide It is used to control the production and flow of growth hormone, and to reduce tumor size.

  • Growth hormone antagonist

    This drug works to block the effects of growth hormone on body tissues. An example of a growth hormone antagonist is: pegvisomant.

Operation

Surgery is generally recommended to remove tumors from the pituitary that are pressing on nerves and triggering excess GH production. The surgery uses an endoscopic technique that is inserted through the nose or upper lip to remove the tumor.

Radiotherapy

Radiotherapy is generally recommended if the tumor cannot be completely removed with surgery and medication. This therapy serves to destroy the remaining tumor cells and suppress growth hormone levels slowly.

Complications of Acromegaly

Untreated acromegaly can lead to complications, such as:

  • Ship passage syndrome (carpal tunnel syndrome).
  • Sleep apnea, which can block the respiratory tract.
  • Osteoarthritis or arthritis.
  • Miscarriage in pregnant women.
  • Hypertension.
  • Diabetes.
  • Heart disease, especially cardiomyopathy.
  • Thyroid disease.
  • Hypopituitarism.
  • The growth of polyps in the colon.
  • Benign tumor growth in the uterus.
  • Pressure on the spinal cord.
  • Blindness.