Acromegaly history and symptoms: Difference between revisions

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{{Acromegaly}}
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==Overview==
==Overview==
Common symptoms of acromegaly include enlarged hands and feet, [[headache]], increase sweating, [[sexual dysfunction]], [[skin]] thickening, deepening of the voice and, an [[Macroglossia|enlarged tongue]].  Less common symptoms of acromegaly include visual defects and irregular menses in the women.
==History and Symptoms==
==History and Symptoms==
Features that result from high level of hGH or expanding tumor include:
===History===
* Soft tissue swelling of the hands and feet
Patients with acromegaly may have a positive history of:
* Brow and lower jaw protrusion
*Rapid onset of acromegaly symptoms development
* Enlarging hands
*Increase in shoe size due to enlarged [[feet]]
* Enlarging feet
*Increase in ring size due to enlarged [[hand]]  
* [[Arthritis]] and [[carpal tunnel syndrome]]
===Common Symptoms===
* Teeth spacing increase
Common symptoms of acromegaly include:<ref name="pmid1521514">{{cite journal| author=Molitch ME| title=Clinical manifestations of acromegaly. | journal=Endocrinol Metab Clin North Am | year= 1992 | volume= 21 | issue= 3 | pages= 597-614 | pmid=1521514 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1521514  }} </ref><ref name="pmid19884662">{{cite journal| author=Melmed S| title=Acromegaly pathogenesis and treatment. | journal=J Clin Invest | year= 2009 | volume= 119 | issue= 11 | pages= 3189-202 | pmid=19884662 | doi=10.1172/JCI39375 | pmc=2769196 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19884662  }} </ref>
* [[Macroglossia]] [enlarged tongue]
*Enlarged hands and feet
* [[Heart failure]]
*Change in the facial features
* [[Kidney failure]]
*[[Headache]]
* Compression of the [[optic chiasm]] leading to loss of vision in the outer visual fields (typically [[bitemporal hemianopia]])
*Increase [[sweating]]  
* [[Headache]]
*[[Paraesthesia]]
* [[Diabetes mellitus]]
*[[Sexual dysfunction]]  
* [[Hypertension]]
*[[Skin]] thickening
* Enlarging heart
*Protrusion of the lower [[mandible]]
* Increased palmar sweating and [[sebum]] production over the face ([[seborrhea]]) are clinical indicators of active growth hormone (GH) producing pituitary tumours. These symptoms can also be used to monitor the activity of the tumour after surgery although biochemical monitoring is confirmatory.
*Deepening of voice
*[[Macroglossia|Enlarged tongue]]


===Less Common Symptoms===
Less common symptoms of acromegaly include:
*Visual defects
*In women, irregular menses


(Image courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, California)
<div align="left">
<gallery heights="175" widths="175">
Image:acromegaly1.jpg|Facial changes secondary to elevated growth hormone levels.  Note in particular prominent supra-orbital ridge, jaw, and generally enlarged facial features.
Image:Acromegaly3.jpg|Markedly enlarged hand resulting from excess growth hormone.  For reference purposes, the comparison hand is size 6 1/2.
Image:acromegaly4.jpg|Facial changes secondary to elevated growth hormone levels.  Note in particular prominent supra-orbital ridge, jaw, and generally enlarged facial features.
</gallery>
</div>
[[Image:Acromegaly facial features.JPEG|thumb|left|Facial aspect of a patient with acromegaly. The nose is widened and thickened, the [[cheekbones]] are obvious, the forehead bulges, the lips are thick and the facial lines are marked. The forehead and overlying skin is thickened, sometimes leading to [[frontal bossing]].]]
[[Image:Acromegaly hands.JPEG|thumb|center|As compared with the hand of a typical person (left), the hand of a patient with acromegaly (right) is enlarged, the fingers are widened, thickened and stubby, and the soft tissue is thickened.]]
[[Image:Acromegaly prognathism.JPEG|thumb|center|[[Mandible|Mandibular]] overgrowth leads to [[prognathism]], maxillary widening, teeth separation and jaw [[malocclusion]].]]
===Pituitary gigantism in children===
This condition of growth hormone excess is rare in children and is referred to as [[gigantism|pituitary gigantism]], because the excessive growth hormone produces excessive growth of bones and the child can achieve excessive height. As an affected child becomes an adult, many of the adult problems can gradually develop. The distinction between gigantism (occurring in children) and acromegaly (occurring in adults) can be made by the occurrence of the adenoma in relation to the closure of the [[Bone#Formation|epiphyses]]. If elevated growth hormone levels occur before the closure of the epiphyses (i.e. in prepubertal children), then gigantism ensues. If it occurs after the closure of the epiphyses (i.e., in adults) then acromegaly ensues.
==References==
==References==
{{reflist|2}}


{{reflist|2}}
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Latest revision as of 21:54, 24 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]

Overview

Common symptoms of acromegaly include enlarged hands and feet, headache, increase sweating, sexual dysfunction, skin thickening, deepening of the voice and, an enlarged tongue. Less common symptoms of acromegaly include visual defects and irregular menses in the women.

History and Symptoms

History

Patients with acromegaly may have a positive history of:

  • Rapid onset of acromegaly symptoms development
  • Increase in shoe size due to enlarged feet
  • Increase in ring size due to enlarged hand

Common Symptoms

Common symptoms of acromegaly include:[1][2]

Less Common Symptoms

Less common symptoms of acromegaly include:

  • Visual defects
  • In women, irregular menses

References

  1. ↑ Molitch ME (1992). "Clinical manifestations of acromegaly". Endocrinol Metab Clin North Am. 21 (3): 597–614. PMID 1521514.
  2. ↑ Melmed S (2009). "Acromegaly pathogenesis and treatment". J Clin Invest. 119 (11): 3189–202. doi:10.1172/JCI39375. PMC 2769196. PMID 19884662.


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