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Acromegaly: Disease Prognosis and Treatment

The endocrine system is an integral part of the human body because it impacts growth and development, sexual mood, and metabolism. Endocrine diseases can occur when hormone levels in the body are too low or too high. Additionally, endocrine disorders can happen if human bodies respond differently to hormones. An example of endocrine disease is acromegalia, which comes about when the human body produces excess growth hormone (National Institute of Diabetes and Digestive and Kidney Diseases, 2020). Acromegaly is a rare disorder that may go unnoticed for long; therefore, it is critical to describe its causes, diagnosis, symptoms, prognosis, and treatment.

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Acromegalia is infrequent, often diagnosed in adults of middle age, and has various complications. Excessive growth hormone (GH) in children causes gigantism instead of hypertrophy. Gigantism happens when too much GH is produced during adolescence and the child’s growth plates close or fuse. Since the symptoms of acromegalia manifest slowly, various health complications can develop before the disorder’s diagnosis. Health complications related to acromegaly include sleep apnea, carpal tunnel syndrome, and high blood pressure. People suffering from hypertrophy have an increased risk of developing colon polyps, which can later progress to colon cancer (National Institute of Diabetes and Digestive and Kidney Diseases, 2020). Acromegalia can cause early death and grave health problems if left untreated.

The causes of acromegaly may be different in various people. When GH enters the bloodstream, the liver is signaled to produce a hormone known as insulin-like growth factor 1 (IGF-1) that causes the growth of body tissues and bones. Elevated levels of IGF-1 change how blood sugar and fats are processed, potentially leading to heart disease and high blood pressure. Frequently, a pituitary adenoma, which is located in the anterior lobe of the pituitary gland, causes acromegaly, with genetic factors playing a huge role. Both pituitary and nonpituitary tumors can cause hypertrophy; however, nonpituitary tumors rarely cause acromegaly. Pituitary tumors are noncancerous and located in the pituitary gland, whereas nonpituitary tumors are found in other body parts (Dineen et al., 2017). Pituitary and nonpituitary tumors lead to decreased cortisol leading to nausea, dizziness, weight loss, and tiredness.

Acromegaly symptoms may differ depending on the person. Typical physical appearance changes include a deeper voice, increased skin odor, sweating, skin tags, bone changes, larger tongue, lips, nose, feet, and hands. A person’s feet and hands can swell and become larger, and some persons can notice shoe size changes. The skin may also become oily, coarse, and thick, while the gaps between teeth may increase. Additionally, the lower jaw and brow jut out, and the nose bridge gets bigger. Other widespread symptoms of acromegaly can include vision problems, joint aches, and headaches (Colao et al., 2019). Since the GH is responsible for developing bones, muscles, and organs, acromegaly affects them all.

Acromegaly can be diagnosed through blood and imaging tests, where the blood screening is done through oral glucose tolerance and IGF tests. The IGF test is used to track GH in the human body by measuring IGF-1 levels in the blood, where high IGF-1 levels indicate that a patient has acromegaly. The oral glucose tolerance test involves a patient drinking a sugary liquid. A measurement of the GH levels is then taken each half-hour. Sugar causes GH levels to fall; however, if the body constantly produces excessive GH, the changes would not be as expected, suggesting an acromegaly diagnosis. Imaging tests, including magnetic resonance imaging (MRI) and computed tomography (CT) scans, are conducted to measure and locate the specific tumor causing acromegaly (Dineen et al., 2017). A CT scan combines computer technology and x-rays to produce images of internal body parts and organs.

The treatment of acromegaly can be achieved through radiation therapy, surgery, and medicines. Acromegaly treatment goals are improving symptoms, managing related health complications, controlling tumor size, and returning IGF-1 and GH levels to normal. Surgeries to remove pituitary tumors can be transsphenoidal, microscopic, and endoscopic. The location and size of tumors determine the surgery’s details. Medicines such as dopamine agonists and somatostatin analogs can treat acromegaly. Both medicine types inhibit tumor growth and GH production; nevertheless, somatostatin analogs are not as effective as dopamine agonists (Colao et al., 2019). Another option to treat acromegaly is using radiation therapy through high-energy x-rays to destroy tumor cells.

In conclusion, it is critical to explore the causes, symptoms, diagnosis, treatment, and description of acromegaly to understand the rare disorder better. The condition is diagnosed through blood and imaging tests, which determine GH levels in the blood. Hypertrophy affects body organs, tissues, and muscles throughout the body. Acromegalia can be characterized by a deeper voice, skin tags, increased skin odor and sweating, and bone changes. The treatment of hypertrophy involves medicines, radiation therapy, and surgery.

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Table 1. Medical Terms

Terms Definition
Growth hormone The hormone responsible for the development of body muscles, tissues, and organs
Gigantism Abnormal growth caused by excess GH in childhood
Colon polyps A clump of cells that is small and usually forms on the colon lining
Carpal tunnel syndrome A condition that makes hands weak or numb
Sleep apnea Sleep condition where breathing stops and starts repeatedly
Colon cancer A cancer type that starts in the large intestines
IGF-1 A hormone that assists in the promotion of normal tissue and bone growth and development
Pituitary adenoma A tumor located in the pituitary gland
Oral glucose tolerance and IGF tests Tests carried out to determine the levels of GH in the blood
MRI A scan that produces detailed images of body tissues and organs by using large radio and magnet waves.
CT scan A scan that uses technology and x-rays to produce cross-sectional body images

References

Colao, A., Grasso, L. F., Giustina, A., Melmed, S., Chanson, P., Pereira, A. M., & Pivonello, R. (2019). Acromegaly. Nature Reviews Disease Primers, 5(1), 1-17. Web.

Dineen, R., Stewart, P. M., & Sherlock, M. (2017). Acromegaly. QJM: An International Journal of Medicine, 110(7), 411-420. Web.

National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Acromegaly. Web.

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