12 August

Acromegaly - Treatment , Symptoms, Causes


General characteristics of the disease

Acromegaly, it is in use gigantism - serious neuroendocrine disease.It causes increased secretion of the hormone somatotropin, the so-called growth hormone.

called acromegaly gigantism in children and adolescent patients.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, and excessive weight gain.

In 99% of cases of acromegaly is caused by pituitary adenoma.Acromegaly occurs pathological increase of internal organs: heart, lung, spleen, liver, intestine, and pancreas.Their hypertrophy fraught sclerosis tissue and the development of multiple organ failure.In addition, a patient with symptoms of acromegaly there is an increased likelihood of benign and malignant tumors.

Acromegaly occurs on average at 50 per 1 million. Man.Gender does not play the role of the patient.The most common pituitary adenoma of acromegaly, and as

a consequence it is diagnosed in people 40-60 years of age.

reasons acromegaly

overwhelming number of cases diagnosed acromegaly results from pure growth hormone adenoma (it somatotropinoma).Acromegaly may 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 acromegaly reasons cited pathology hormone secretion:

  • TSH (thyroid stimulating hormone),
  • LH (luteinizing hormone, or lyuteotropina),
  • FSH (follicle stimulating hormone),
  • a-subunit and other

reason.acromegaly in most cases are somatotrofov mutation.So it called special type of pituitary secretory granules.

Acromegaly may also develop as a consequence of the syndrome MEN-1 (multiple endocrine neoplasia).This disease is characterized by the formation of the etiology of hereditary multiple tumors in the pituitary, thyroid and thymus glands, adrenal, nervous system and the gastrointestinal tract.

Symptoms of acromegaly

symptoms of acromegaly have a slow rate of increase.On average, an adult disease is diagnosed only after 10 years after the manifestation of the first symptoms of acromegaly.

By main symptoms of acromegaly include changes in appearance.It is thanks to them - coarsening of facial features, increase the cheekbones, brow ridges, the 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.During the further progression of the disease there is a change of occlusion due to the growth of the interdental spaces.

patients childhood and adolescence is the main symptom of acromegaly excessive linear growth pace, outpacing all age norms.

Among other symptoms of acromegaly is called:

  • arthralgia (excessive formation of cartilaginous tissue),
  • excessive sweating and excessive activity of the sebaceous glands,
  • seal the top layer of skin,
  • visceromegaly (increase spleen)
  • degeneration of muscle fibers, causingdecreased 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 proliferation of airway tissues.

Acromegaly - also a cause of erectile dysfunction in men and menstrual irregularities in women of childbearing age.

diagnosis of acromegaly Acromegaly

diagnosed based on data from studies of blood at the level of IGF-1 (somatomedin C).Under normal rates holding provocative test is recommended to load glucose.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 important to the exclusion of the possible complications of acromegaly: diabetes, intestinal polyposis, cardiac failure, goitre, etc.

treatment of acromegaly

main goal of treatment of acromegaly - normalization of production of growth hormone.To do this, the patient underwent surgical removal of pituitary adenoma.Surgical treatment of acromegaly, provoked by 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 analogs: Octreotide and lanreotide.Due to their regular use in 50% of patients manage to normalize the levels of hormones, and also cause a reduction in tumor size pituitary.

decrease the synthesis of growth hormone can also reception blockers somatotrofov receptors, for example, Pegvisomantomom.This method of treatment of acromegaly still needs further study.

radiation treatment of acromegaly is considered to be ineffective as an independent method of treatment and can be used only as part of comprehensive measures to combat the disease.

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