Acromegaly

Background:
Acromegaly occurs in approximately 6 in 100,000 adults. It is characterized by excessive amounts of growth hormone being produced even after the skeleton and organs stop developing. This increase in hormone is usually caused by a noncancerous tumor of the pituitary gland.

Pathway:
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Figure 1. Normal function of pituitary gland.

Symptoms/Affected Areas:

-Extensive growth of body and limbs.
-Decreased muscle strength
-Joint pain
-Large hands and feet
-Limited joint movement
-Excess hair growth in females
-High Growth Hormone levels
-High insulin-like growth factor 1 levels (IGF-1)
-Enlarged Heart

History:
Acromegaly has been documented since the early 1500’s. However, it was not until the late 1800’s when Woods Hutchinson described his observations of gigantism with pituitary tumors. The debate of the actual cause ran well into the 1900’s and until growth hormone was isolated in 1944. Then it was not until the 1950s that insulin-like growth factors were discovered by Salmon and Daughaday. It was finally concluded that these factors are what cause Acromegaly.

Andre the Giant, a professional actor and wrestler lived with Acromegaly and stood and 7 feet 4 inches tall. He refused surgery throughout his life and died at the age of 46 due to heart complications.

Treatments:
-Radiation Therapy
-Endonasal Transphenoidal (tumor removal)
-Growth Hormone Receptor Antagonists (blocks HGH)

Current Research:
Researchers today are more focused on developing less invasive treatments. The overall function of the disease is fairly well known to the extent that individuals are evaluated and the best option whether it be surgery, radiation therapy or Growth hormone receptor antagonist injections.

References:
[1] Acromegaly: A.D.A.M. Medical Encyclopedia (2011) http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001364/
[2] Acromegaly Wikipedia Page: http://en.wikipedia.org/wiki/Acromegaly
[3] Antonios Mammis, Jean Eloy and James Liu. Early Descriptions of Acromegaly and Gigantism and Their Historical Evolution as Clinical Entities: Historical Vignette (2010).
[4] Karli Edling and Anthony Heaney. An Update on the Treatment of Acromegaly (2013)