Acromegaly and its Diagnosis
Uploaded by srheric on Apr 23, 2007
Acromegaly and its Diagnosis
Acromegaly (Greek for “appendage enlargement”) is a rare but very serious disease frequently referred to as “Gigantism” or “Giantism.” It is the direct result of an overproduction and secretion of the adenohypophyseal growth hormone GH. True to its name, the disease is characterized by an enlargement of the organs, bones, and soft tissues, as well as a thickening of the skin and bodily membranes; and is frequently difficult to diagnose, as symptoms often do not appear until middle age. Typically the disease results in heart failure caused by an enlargement of the heart, organ failure due to pressure or thickening of the outer membrane of the organ, or brain hemorrhaging caused by a benign or malignant pituitary adenoma. To date, there are three known forms of the disease: Cushing’s disease, Nelson Syndrome, and Prolactinoma. Each is characterized by different phenotypic attributes commonly linked by an enlargement of all or some particular body parts. Prolactinoma is the most frequently recognized form of giantism. It is characterized by an overall enlargement of the body, and was brought to public attention nearly twenty years ago by pro-wrestler and actor Andre the Giant, who later died of heart failure in the early 1990s. Nelson’s disease and Cushing Syndrome are similar to each other, however there is now controversy as to whether these two diseases are even linked to Prolactinoma since they are not commonly characterized by an overall enlargement of the body, but rather an extreme overproduction of soft and fatty tissue. These diseases cause thickening of the bones, skin, and soft tissue, but often appear after the person has finished growing, making the patient appear overweight and unable to speak and move with fluidity since the tongue and hands are hindered. All three diseases tend to have the same outcome: organ failure or brain hemorrhaging.
In the past twenty years, controversy has arisen as to whether there are in fact three forms of the disease, what characterizes differentiation between each one, and how should each be treated accordingly. The problem is until recently, scientists have based their diagnoses almost entirely upon phenotypic characteristics and what is known about pituitary adenomata; only now are scientists beginning to analyze the genes and hormones involved on the micro level. The following articles examine methods in which...