Endocrine System >

“Increased growth hormone eg due to Adenoma (in children would cause gigantism)”

  1. Pituitary adenoma
  2. Increased Growth hormone secretion
  3. Acromegaly (disproportional skeletal, tissue and organ growth)
Clinical Presentation
  • Coarse facial appearance
  • Spade like hands
  • “Wedding ring doesn’t fit anymore” or “Change in shoe size”
  • Sweating and oily skin
  • Headaches
  • Bloods:
    • IGF screening (normal Growth factor not useful)
  • Imaging:
    • MRI or CT + visual field tests to determine size and position of adenoma
  • Special:
    • Oral glucose GH suppression testing to confirm the diagnosis
      • if normal GH concentration falls with oral glucose but in Acromegaly remains high
  • 1st line – surgery
  • 2nd line – Medical treatment
    • Somatostatin analogues (octreotide) injections reduce Growth hormone secretions
    • Dopamine agonists to inhibit Growth hormone release from tumour
  • Diabetes
  • Cardiomyopathy
  • Heart Failure
  • IHD
  • Hypertension
  • Carpal-Tunnel Syndrome
  • Kyphosis
  • Neoplasia especially colorectal
  • Obstructive Sleep Apnea

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