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Acromegaly is a rare hormonal disorder caused by excess growth hormone production, leading to characteristic enlargement of the hands, feet, and facial features.
Acromegaly is a rare hormonal disorder caused by excess growth hormone production, leading to characteristic enlargement of the hands, feet, and facial features.
Acromegaly is a rare, chronic metabolic disorder caused by the excessive production of growth hormone (GH). The name derives from the Greek words akron (extremity) and megas (large). The condition primarily affects adults and leads to abnormal growth of the extremities -- the hands, feet, and face. Since skeletal growth is already complete in adults, the disorder does not increase overall height but instead causes a coarsening and widening of bones and soft tissues.
In approximately 95% of cases, acromegaly is caused by a benign tumor of the pituitary gland called a pituitary adenoma. This tumor produces uncontrolled amounts of growth hormone. GH stimulates the liver to produce IGF-1 (Insulin-like Growth Factor 1), which in turn drives excessive tissue growth.
Symptoms develop gradually over many years and are therefore often diagnosed late. Typical signs and symptoms include:
The diagnosis of acromegaly is based on clinical examination, laboratory tests, and imaging:
The goal of treatment is to normalize GH and IGF-1 levels, remove the tumor, and prevent long-term complications.
Transsphenoidal surgery (accessing the pituitary gland through the nasal cavity) is the preferred first-line treatment. In cases of small tumors (microadenomas), complete cure can often be achieved.
Radiation therapy (conventional or as radiosurgery/Gamma Knife) is used when surgery and medical therapy are insufficient. The effect is delayed and may cause hypopituitarism (underactivity of the pituitary gland).
With early diagnosis and successful treatment, a good quality of life can be achieved. Left untreated, acromegaly significantly increases the risk of severe cardiovascular disease, diabetes, spinal changes, and colorectal polyps. Lifelong follow-up examinations are necessary.
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