General characteristics of the disease
Acromegaly, it is also in use gigantism - serious neuroendocrine disease. It causes increased secretion of the hormone somatotropin, the so-called growth hormone.
Gigantism is called acromegaly patients childhood and adolescence. Increased production of growth hormone in them leads to excessive linear growth. Patients adulthood for acromegaly is characterized by overgrowth of soft tissue and periosteum as well as excessive weight gain.
In 99% of cases, acromegaly is caused by pituitary adenoma. Acromegaly occurs pathological increase of internal organs: heart, lung, spleen, liver, intestine, and pancreas. Their fraught sclerosis tissue hypertrophy and development of multiple organ failure. In addition, a patient with symptoms of acromegaly there is an increased probability of benign and malignant tumors.
Acromegaly occurs at an average of 50 per 1 million. People. Sex of the patient is not important. The most common acromegaly and pituitary adenoma as its consequence, are diagnosed in people aged 40-60.
Reasons for acromegaly
The overwhelming number of cases diagnosed acromegaly is the result of net growth hormone adenoma (it somatotropinoma). Acromegaly can also be combined. The reason for this type of adenoma is excessive secretion of growth hormone and prolactin or growth hormone and other hormones adenogipofizarnyh species.
So among the causes of disease called acromegaly hormone secretion:
- TSH (thyroid stimulating hormone)
- LH (luteinizing hormone, or lyuteotropina)
- FSH (follicle stimulating hormone),
- a-subunit and others.
The cause in most cases of acromegaly are mutations somatotrofov. So a special type called secretory granules of the pituitary gland.
Acromegaly may also develop as a consequence of the syndrome MEN-1 (multiple endocrine neoplasia). This disease is characterized by the formation of genetic etiology of numerous tumors in the pituitary, thyroid and thymus glands, adrenal, nervous system and gastrointestinal tract.
Symptoms of acromegaly
Symptoms of acromegaly have a slow rate of increase. On average, an adult disease is diagnosed only 10 years after the manifestation of the first symptoms of acromegaly.
Among the main symptoms of acromegaly include changes in appearance. It is thanks to them - coarsening of facial features, increase the cheek bones, brow, lower jaw - a person may suspect that he had the disease.
Soft tissue in a patient with symptoms of acromegaly hypertrophied: slightly enlarged tongue, ears, nose, lips, hands and feet. In the further progression of the disease is a change of occlusion due to the growth of the interdental spaces.
Patients childhood and adolescence is the main symptom of acromegaly excessive tempo of linear growth, outpacing all age norms.
Among other symptoms of acromegaly is called:
- arthralgia (excessive formation of cartilage)
- increased sweating, and excessive activity of the sebaceous glands,
- seal the top layer of skin,
- visceromegaly (increased spleen)
- degeneration of muscle fibers, causing decreased performance and low physical activity.
Chronic overproduction of growth hormone in acromegaly can lead to multiple organ failure. Acromegaly symptom of late stage development is myocardial hypertrophy, heart failure, and increased intracranial pressure.
In 90% of patients with symptoms of acromegaly is diagnosed apnea syndrome - a threat to stop breathing during sleep caused by the growth of the tissues of the respiratory tract.
Acromegaly - as the cause of erectile dysfunction in men and menstrual disorders in women of childbearing age.
Diagnosis of acromegaly
Acromegaly is diagnosed on the basis of blood tests on the level of IGF-1 (somatomedin C). Under normal indicators recommended that a provocative test with a glucose load. To do this, a patient suspected of having acromegaly blood is taken every 30 minutes, 4 times a day.
To visualize the causes acromegaly - pituitary adenoma performed brain MRI. In the diagnosis of the disease is also important exception of complications of acromegaly: diabetes, intestinal polyposis, cardiac failure, goiter, etc.
Treatment of acromegaly
The main objective of the treatment of acromegaly - normalization produce growth hormone. To do this, patients underwent surgical removal of the pituitary adenoma. Surgical treatment of acromegaly, provoked tumors of small size in 85% of cases leads to the normal secretion of hormones and sustained remission. Surgical treatment of acromegaly caused by a tumor of the pituitary gland of large dimensions, is effective only in a third of cases.
In the conservative treatment of acromegaly growth hormone antagonists are used - artificial hormone somatostatin analogues: Octreotide and lanreotide. Thanks to their regular use in 50% of patients manage to normalize hormone levels and cause a reduction in the size of the pituitary tumor.
Reduce the synthesis of growth hormone can also somatotrofov reception receptor blockers, such as Pegvisomantomom. This method of treatment of acromegaly still needs further study.
Radiation treatment of acromegaly is considered ineffective as a method of self-therapy and may be used only as part of comprehensive measures to combat the disease.