What is acromegaly: description, symptoms, disease prevention

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Acromegaly - a pathological increase in certain parts of the body associated with increased production of growth hormone (growth hormone) by the anterior pituitary gland as a result of its tumor lesion. It occurs in adults and is manifested by enlargement of facial features (nose, ears, lips, lower jaw), an increase in the feet and hands, constant headaches and joint pain, impaired sexual and reproductive functions in men and women. Elevated levels of growth hormone in the blood cause early mortality from cancer, pulmonary, cardiovascular diseases.

Video (click to play).

Acromegaly - a pathological increase in certain parts of the body associated with increased production of growth hormone (growth hormone) by the anterior pituitary gland as a result of its tumor lesion. It occurs in adults and is manifested by enlargement of facial features (nose, ears, lips, lower jaw), an increase in the feet and hands, constant headaches and joint pain, impaired sexual and reproductive functions in men and women. Elevated levels of growth hormone in the blood cause early mortality from cancer, pulmonary, cardiovascular diseases.

Video (click to play).

Acromegaly begins to develop after the cessation of body growth. Gradually, over a long period, symptoms increase, and changes in appearance occur. On average, acromegaly is diagnosed after 7 years from the actual onset of the disease. The disease is equally found among women and men, mainly at the age of 40-60 years. Acromegaly is a rare endocrine pathology and is observed in 40 people per 1 million population.

The secretion of growth hormone (growth hormone, STH) is carried out by the pituitary gland. In childhood, growth hormone controls the formation of the musculoskeletal skeleton and linear growth, while in adults it controls the carbohydrate, fat, water-salt metabolism. The secretion of growth hormone is regulated by the hypothalamus, which produces special neurosecrets: somatoliberin (stimulates the production of GH) and somatostatin (inhibits the production of GH).

Normally, the somatotropin content in the blood fluctuates during the day, reaching its maximum in the morning hours. In patients with acromegaly, there is not only an increase in the concentration of STH in the blood, but also a violation of the normal rhythm of its secretion. For various reasons, cells of the anterior pituitary gland do not obey the regulatory influence of the hypothalamus and begin to multiply actively. The proliferation of pituitary cells leads to the appearance of a benign glandular tumor - pituitary adenoma, which intensively produces somatotropin. The size of the adenoma can reach several centimeters and exceed the size of the gland itself, squeezing and destroying normal pituitary cells.

In 45% of patients with acromegaly, pituitary tumors produce only somatotropin, another 30% additionally produce prolactin, in the remaining 25%, in addition, luteinizing, follicle-stimulating, thyroid-stimulating hormones, A subunit are secreted. In 99%, it is the pituitary adenoma that causes acromegaly. The factors causing the development of the pituitary adenoma are traumatic brain injuries, hypothalamic tumors, chronic sinus inflammation (sinusitis). A certain role in the development of acromegaly is assigned to heredity, since the disease is more often observed in relatives.

In childhood and adolescence, against the background of continued growth, chronic STH hypersecretion causes gigantism, characterized by an excessive, but relatively proportional increase in bones, organs and soft tissues. With the completion of physiological growth and ossification of the skeleton, disorders of the type of acromegaly develop - disproportionate thickening of bones, an increase in internal organs and characteristic metabolic disorders. With acromegaly, hypertrophy of the parenchyma and stroma of the internal organs: heart, lungs, pancreas, liver, spleen, intestines. The growth of connective tissue leads to sclerotic changes in these organs, the risk of developing benign and malignant tumors, including endocrine ones, increases.

Acromegaly is characterized by a long, perennial course. Depending on the severity of symptoms in the development of acromegaly, there are several stages:

  • Stage of preacromegaly - initial, mild signs of the disease appear. At this stage, acromegaly is rarely diagnosed, solely by indicators of the level of growth hormone in the blood and by CT of the brain.
  • Hypertrophic stage - pronounced symptoms of acromegaly are observed.
  • Tumor stage - symptoms of compression of adjacent brain regions (increased intracranial pressure, nerve and eye disorders) come to the fore.
  • Stage cachexia - exhaustion as the outcome of acromegaly.

Manifestations of acromegaly can be due to an excess of growth hormone or the action of the pituitary adenoma on the optic nerves and nearby brain structures.

Excess growth hormone causes characteristic changes in the appearance of patients with acromegaly: an increase in the lower jaw, zygomatic bones, eyebrows, hypertrophy of the lips, nose, ears, leading to coarsening of facial features. With an increase in the lower jaw, there is a discrepancy in the interdental spaces and a change in the bite. There is an increase in the tongue (macroglossia), on which teeth marks are imprinted. Due to hypertrophy of the tongue, larynx and vocal cords, the voice changes - it becomes low and hoarse. Changes in appearance with acromegaly occur gradually, imperceptibly for the patient. There is a thickening of the fingers, an increase in the size of the skull, feet and hands so that the patient is forced to purchase hats, shoes and gloves several sizes larger than before.

With acromegaly, skeletal deformation occurs: the spine bends, the chest in the anteroposterior size increases, acquiring a barrel-shaped form, the intercostal spaces expand. Developing hypertrophy of the connective and cartilage tissues causes deformation and restriction of joint mobility, arthralgia.

With acromegaly, excessive sweating and sebum secretion are noted, due to an increase in the number and increased activity of sweat and sebaceous glands. The skin in patients with acromegaly thickens, thickens, and gathers in deep folds, especially in the scalp.

With acromegaly, an increase in the size of muscles and internal organs (heart, liver, kidneys) occurs with a gradual increase in dystrophy of muscle fibers. Patients begin to worry about weakness, fatigue, a progressive decline in performance. Myocardial hypertrophy develops, which is then replaced by myocardial dystrophy and increasing heart failure. A third of patients with acromegaly have arterial hypertension, almost 90% develop carotid apnea syndrome associated with hypertrophy of the soft tissues of the upper respiratory tract and impaired functioning of the respiratory center.

With acromegaly, sexual function suffers. Most women with an excess of prolactin and a deficiency of gonadotropins develop menstrual irregularities and infertility, galactorrhea appears - the discharge of milk from the nipples, not caused by pregnancy and childbirth. 30% of men have a decrease in sexual potency. Hyposecretion of antidiuretic hormone with acromegaly is manifested by the development of diabetes insipidus.

As the pituitary gland tumor grows and the nerves and tissues are compressed, an increase in intracranial pressure, photophobia, double vision, pain in the cheekbones and forehead, dizziness, vomiting, hearing loss and smell, numbness of the extremities. In patients suffering from acromegaly, the risk of developing tumors of the thyroid gland, organs of the gastrointestinal tract, and uterus is increased.

The course of acromegaly is accompanied by the development of complications from almost all organs. The most common in patients with acromegaly are heart hypertrophy, myocardial dystrophy, arterial hypertension, heart failure. More than a third of patients develop diabetes mellitus, liver dystrophy and pulmonary emphysema are observed.

Hyperproduction of growth factors with acromegaly leads to the development of tumors of various organs, both benign and malignant. Acromegaly is often accompanied by diffuse or nodular goiter, fibrocystic mastopathy, adenomatous adrenal hyperplasia, polycystic ovaries, uterine fibroids, intestinal polyposis. Developing pituitary insufficiency (panhypopituitarism) is due to compression and destruction of the pituitary gland tumor.

In the later stages (5-6 years after the onset of the disease), acromegaly can be suspected on the basis of an increase in body parts and other external signs that are noticeable during examination. In such cases, the patient is referred for consultation by the endocrinologist and tests for laboratory diagnostics.

The main laboratory criteria for the diagnosis of acromegaly are the determination of blood levels:

  • growth hormone in the morning and after the glucose test,
  • IRF I - insulin-like growth factor.

An increase in growth hormone levels is determined in almost all patients with acromegaly. An oral test with a glucose load during acromegaly involves determining the initial value of STH, and then after taking glucose - after half an hour, an hour, 1.5 and 2 hours. Normally, after taking glucose, the level of growth hormone decreases, and with the active phase of acromegaly, on the contrary, its increase is noted. The glucose tolerance test is especially informative in cases of moderate increase in the level of STH, or its normal values. A glucose load test is also used to evaluate the effectiveness of acromegaly treatment.

Growth hormone acts on the body through insulin-like growth factors (IRF). The plasma concentration of IRF I reflects the total release of GH per day. An increase in IRF I in the blood of an adult directly indicates the development of acromegaly.

An ophthalmological examination in patients with acromegaly has a narrowing of the visual fields, since anatomically visual pathways are located in the brain near the pituitary gland. When radiography of the skull reveals an increase in the size of the Turkish saddle, where the pituitary gland is located. To visualize the pituitary tumor, computer diagnostics and MRI of the brain are performed. In addition, patients with acromegaly are examined for various complications: intestinal polyposis, diabetes mellitus, multinodular goiter, etc.

With acromegaly, the main goal of treatment is to achieve remission of the disease by eliminating somatotropin hypersecretion and normalizing the concentration of IRF I. For the treatment of acromegaly, modern endocrinology uses medical, surgical, radiation and combined methods.

To normalize the level of somatotropin in the blood, the administration of somatostatin analogues is prescribed - a neurosecret of the hypothalamus, which suppresses the secretion of growth hormone (octreotide, lanreotide). With acromegaly, the appointment of sex hormones, dopamine agonists (bromocriptine, cabergoline) is indicated. Subsequently, one-time gamma or radiation therapy is usually performed on the pituitary gland.

With acromegaly, the most effective is the surgical removal of the tumor at the base of the skull through the sphenoid bone. With small adenomas after surgery, 85% of patients have normalized growth hormone levels and persistent remission of the disease. With a significant tumor, the percentage of cure as a result of the first operation reaches 30%. The mortality rate for surgical treatment of acromegaly is from 0.2 to 5%.

The lack of treatment for acromegaly leads to disability of patients of active and working age, increases the risk of premature mortality. With acromegaly, life expectancy is reduced: 90% of patients do not live up to 60 years. Death usually occurs as a result of cardiovascular disease. The results of surgical treatment of acromegaly are better with small sizes of adenomas. With large tumors of the pituitary gland, the frequency of their relapses sharply increases.

To prevent acromegaly, head injuries should be avoided, and chronic foci of nasopharyngeal infection should be sanitized. Early detection of acromegaly and normalization of growth hormone levels will help to avoid complications and cause persistent remission of the disease.

The root causes and stages of acromegaly

The pituitary gland produces somatotropic hormone (STH), which is responsible for the formation of the musculoskeletal skeleton in childhood, and in adults monitors the water-salt metabolism.

In patients with acromegaly, there is a violation of the production of this hormone and an increase in its concentration in the blood. Pituitary adenoma with acromegaly occurs with the growth of pituitary cells.

According to experts, the most common cause of acromegaly is precisely the pituitary adenoma, which can form in the presence of hypothalamic tumors, head injuries, and chronic sinusitis. An important role in the development of acromegaly is played by the hereditary factor.

Acromegaly is characterized by a long-term course, its manifestations depend on the stage of development:

Preacromegaly is characterized by a slight increase in the level of GH, as a result of which there are practically no signs of the manifestation of pathology,

Hypertrophic stage - pronounced symptoms of the disease are observed,

The tumor stage is characterized by an increase in intracranial pressure and disturbances in the functioning of the visual and nervous system,

Cachexia - patient attrition is observed.

Due to the long development in the first stage of acromegaly, no external signs are observed.

Clinical manifestations

Symptoms of acromegaly in children and adults include:

Soreness in the spinal column and joints due to their destabilization and the development of arthropathy,

Excessive male hairiness in women,

The expansion of the spaces between the teeth, the increase in various parts of the face, the thickening of the skin,

The appearance of villous-warty growths,

Thyroid enlargement,

Reduced ability to work, fatigue,

The development of cardiovascular pathologies that can lead to death,

Development of diabetes

Violation of pigmentation of the skin,

Disruption of the respiratory system.

With pituitary acromegaly, compression of healthy cells occurs, which provokes:

Decreased potency and libido in men,

Infertility, menstruation in women,

Frequent migraines that are not amenable to medical treatment.

Diagnosis

Diagnosis of acromegaly and gigantism is possible on the basis of data: brain MRI, symptoms, radiography of the foot, biochemical parameters.

Among laboratory studies, the determination of the concentration of STH and insulin-like growth factor-1 is distinguished. Normally, the level of STH is not more than 0.4 μg / l, and IRF-1 correspond to standard indicators according to the gender and age of the subject. With deviations, the presence of the disease cannot be ruled out.

Radiography of the foot is performed to assess the thickness of its soft tissues. Reference values ​​in men up to 21 mm, in women - up to 20 mm.

If the diagnosis is already established, a study of the pathogenesis of acromegaly and determination of deviations in the pituitary and hypothalamus.

Computed tomography of the pelvic organs, chest, retroperitoneum, and mediastinal organs is performed in the absence of pituitary pathologies and the presence of biochemical and clinical manifestations of acromegaly disease.

Therapeutic measures for acromegaly

The main goal of therapeutic measures for such a pathology is to normalize the production of growth hormone, that is, bringing it into a state of remission.

For this, the following methods are used:

Surgical therapy is used in two forms: transcranial and transgenic. The choice is made by a neurosurgeon. Surgery is performed to remove microadenomas or partial resection of macroadenomas.

Radiation exposure is carried out in the absence of effect after surgical therapy, for this gamma knives, a proton beam, a linear accelerator can be used.

In drug therapy, the following groups of drugs are used: somatotropic hormone antagonists, somatostatin analogues, dopaminergic drugs.

The combined treatment method is used according to the doctor's recommendations.

The choice of therapeutic measures should be carried out in conjunction with a specialist who has studied the pathogenesis of acromegaly, symptoms and results of biochemical studies of the patient.

According to statistics, surgery is considered the most effective, about 30% of those operated on fully recover, and the rest have a period of persistent remission.

For preventive purposes, it is recommended:

Timely treatment of diseases affecting the nasopharynx,

Avoid head injuries.

If any doubtful signs occur, consult an endocrinologist for advice. It is not necessary to independently diagnose and even more so treat.

The clinical manifestations of acromegaly are due to increased production of growth hormone, a specific growth hormone that is synthesized by the pituitary gland, or diseases that cause the development of tumor formations (pituitary adenomas, brain tumors, metastases from distant organs).

The causes of the development of the disease lie in the overproduction of somatotropic hormone, which is primarily pituitary in nature, or has a hypothalamic origin.

It is generally accepted that the pathological process that develops at an early age, an advantage in the teenage period, is called gigantism. A characteristic feature of gigantism in children is the rapid and proportional growth of organs, tissues, skeleton bones, hormonal changes. A similar process that develops after the cessation of growth of the body, in more adult age is called acromegaly. The characteristic symptoms of acromegaly are considered to be a disproportionate increase in organs, tissues and bones of the body, as well as the development of concomitant diseases.

Signs of gigantism in children

Early signs of acromegaly (gigantism) in children can be detected some time after the onset of its development. Outwardly, they are manifested in enhanced growth of the limbs, which unnaturally thicken and become loose. At the same time, you can notice that the zygomatic bones, eyebrows increase, there is hypertrophy of the nose, forehead, tongue and lips, as a result of which the facial features change, becoming rougher.

Internal disturbances are characterized by edema in the structures of the throat and sinuses, which causes a change in the timbre of the voice, making it lower. Some patients complain of snoring. In the photo, acromegaly in children and adolescents is manifested by high growth, unnaturally enlarged parts of the body, elongated limbs due to uncontrolled expansion of the bones. The development of the disease is also accompanied by hormonal changes, the symptoms of which are:

hypersecretion of the sebaceous glands,

increased blood sugar

high urine calcium

the likelihood of developing gallstone disease,

thyroid edema and impaired functioning.

Often at an early age, a characteristic proliferation of connective tissues is observed, which causes the appearance of tumor formations and a change in the internal organs: heart, liver, lungs, intestines. Quite often you can see in the photo of newborn children with neck acromegaly, a characteristic feature of which is the lengthening of the sternocleidomastoid muscle.

Symptoms of Acromegaly in Adults

Hyperproduction of growth hormone causes pathological disorders in the body of an adult, which lead to a change in his appearance, which can clearly be seen in his photo or in person. As a rule, this is manifested in the disproportionate growth of certain parts of the body, including the upper and lower limbs, hands, feet, and skull. As in children, in adult patients, the forehead, nose, lip shape, eyebrows, zygomatic bones, lower jaw change, as a result of which the interdental spaces increase. Most patients have macroglossia, a pathological enlargement of the tongue.

Symptoms of acromegaly, which are caused in most cases by pituitary adenoma in adults, include skeletal deformity, in particular, curvature of the spinal column, enlargement of the chest, followed by expansion of the intercostal spaces, and pathological joint changes. Hypertrophy of cartilage and connective tissue leads to a limitation of joint mobility, resulting in arthralgia.

Often patients complain of frequent headaches, fatigue, muscle weakness, decreased performance. This is due to an increase in muscle size with subsequent degeneration of muscle fibers. At the same time, the appearance of myocardial hypertrophy, passing into myocardial dystrophy, causing the development of heart failure, is possible.

Patients with acromegaly symptoms progressing are often shown characteristic changes in their appearance that make them similar. However, internal organs and systems are also undergoing changes. So in women the menstrual cycle is violated, infertility develops, galactorrhea - the release of milk from the nipples in the absence of pregnancy. Many patients, regardless of gender and age, are diagnosed with sleep apnea syndrome, in which severe snoring develops.

If untreated, as a rule, the prognosis remains disappointing. The progression of pathological disorders leads to complete disability, and also increases the risk of premature death that occurs as a result of heart disease. The life expectancy of patients with the disease acromegaly is significantly reduced and does not reach 60 years.

Diagnostics

Diagnosing acromegaly is quite simple, especially in the later stages, since its external manifestations are specific. However, there is a certain category of diseases, the symptoms of which are largely similar to signs of acromegaly. To conduct differential diagnosis and confirm (or exclude) the presence of acromegaly, an endocrinologist's consultation is prescribed, as well as visual, laboratory and instrumental methods for diagnosing acromegaly.

Visual examination of the patient

Before prescribing the necessary diagnostic procedures and proper treatment, the doctor collects an anamnesis, determines a hereditary predisposition to the development of this disease, and also conducts an objective examination - palpation, percussion, auscultation. Based on the results of the initial examination, the necessary diagnostic procedures are prescribed.

Laboratory diagnostic methods

For the diagnosis of acromegaly, traditional laboratory tests are used: blood and urine tests. However, the most informative and therefore often used of them are considered to be the definition of hormones in the blood with acromegaly: STH - somatotropic growth hormone, and insulin-like growth factor - IGF-1.

Determining the level of STH

Confirmation of the development of gigantism or acromegaly is the increased content of somatotropin in the blood - growth hormone, which is produced by the anterior pituitary gland. A distinctive feature of the production of STH is the cyclical nature, therefore, to conduct a test to determine its level, multiple blood sampling is practiced:

in the first case, a three-time sampling is performed with an interval of 20 minutes., after which the serum is mixed and the average level of STH is determined,

in the second case, a five-fold blood sampling is performed with an interval of 2.5 hours, but the level is determined after each receipt of a portion of blood. The final indicator is obtained by averaging all values.

Confirmation of the diagnosis of acromegaly is possible if the hormone level exceeds 10 ng / ml. The disease can be excluded if the average value does not exceed 2.5 ng / ml.

Determination of the level of IGF-1

Another informative screening test is the determination of the level of the hormone IGF-1. It has high sensitivity and specificity, because it does not depend on diurnal fluctuations, like growth hormone. If the level of IGF-1 in the blood exceeds the norm, the doctor may diagnose acromegaly. However, this test should be carried out in conjunction with other studies, since the value of IGF-1 may vary under the influence of some factors:

be reduced in case of impaired liver function, hypothyroidism, excess estrogen, starvation,

be increased as a result of hormone replacement therapy, as well as with an increase in insulin levels in the blood.

Glucose tolerance test

In case of doubtful results, a test for determining STH using glucose is performed to clarify the diagnosis. For its conduct, the basal level of growth hormone is measured, after which the patient is invited to take a glucose solution. In the absence of acromegaly, a glucose test shows a decrease in the secretion of STH, and with the development of the disease, on the contrary, its increase.

CT or MRI

The main and highly informative diagnostic method is CT or MRI, which allows you to identify pituitary adenoma, as well as its degree of spread to regional organs and tissues. The procedure is carried out using a contrast agent that accumulates in the altered tissues, which simplifies the study procedure and allows you to determine the characteristic changes in the pituitary or hypothalamus.

In the process of conducting diagnostic measures, many patients are interested in how often MRI should be done with acromegaly. This procedure is usually carried out at the stage of hypertrophy of individual parts of the body, developed clinical appearances, and later, at the tumor stage, when the patient complains of increased fatigue, headaches, muscle and joint pain, as well as other related manifestations.

X-ray of the skull

This procedure is carried out in order to identify the characteristic radiological manifestations of acromegaly, as well as signs of the development of the pituitary adenoma:

increase in the size of the Turkish saddle,

increased pneumatization of the sinuses,

In the process of radiography in the early stages of the disease, these signs may be absent, therefore, other, often auxiliary, diagnostic methods are prescribed:

radiography of the feet, which allows you to determine the thickness of the soft tissues in this area,

examination by an ophthalmologist to identify edema, stasis and optic atrophy, which often leads to blindness.

If necessary, the patient is prescribed an examination to identify complications: diabetes, intestinal polyposis, nodular goiter, adrenal hyperplasia, etc.

Acromegaly refers to diseases whose treatment cannot be postponed until later. Excessive production of growth hormone can lead to early disability and reduce the chances of a long life. If you have the first symptoms, you should consult a doctor. Only a doctor after conducting all examinations can diagnose the disease and prescribe the correct treatment.

Objectives and Methods

The main goals of acromegaly treatment are:

decreased secretion of growth hormone (growth hormone),

decreased production of insulin-like growth factor IGF-1,

reduction of pituitary adenoma,

The treatment is carried out in the following ways:

After clinical studies, the doctor selects the most suitable method, taking into account the course of the disease and the individual characteristics of the patient. Often, acromegaly, the treatment of which requires a thorough approach, is carried out comprehensively, combining different techniques.

General information

Acromegaly - a pathological increase in certain parts of the body associated with increased production of growth hormone (growth hormone) by the anterior pituitary gland as a result of its tumor lesion. It occurs in adults and is manifested by enlargement of facial features (nose, ears, lips, lower jaw), an increase in the feet and hands, constant headaches and joint pain, impaired sexual and reproductive functions in men and women. Elevated levels of growth hormone in the blood cause early mortality from cancer, pulmonary, cardiovascular diseases.

Acromegaly begins to develop after the cessation of body growth. Gradually, over a long period, symptoms increase, and changes in appearance occur. On average, acromegaly is diagnosed after 7 years from the actual onset of the disease. The disease is equally found among women and men, mainly at the age of 40-60 years. Acromegaly is a rare endocrine pathology and is observed in 40 people per 1 million population.

Surgical intervention

The most effective treatment for acromegaly is considered to be an operation to remove pituitary adenoma. Doctors recommend surgery for both microadenoma and macroadenoma. If rapid tumor growth is noted, surgery is the only chance for recovery.

Surgery is performed in one of two ways:

Minimally invasive method. The tumor is removed promptly without incisions in the head and craniotomy. All surgical operations are performed through the nasal opening using endoscopic equipment.

The transcranial method. This method of surgery is used only if the tumor has reached a large size and removal of the adenoma through the nose is impossible. Both the operation and the rehabilitation period are difficult, because craniotomy is performed.

Sometimes acromegaly returns after surgery. The smaller the tumor, the more likely it is that the period of remission will be long. To reduce risks, it is necessary to undergo a medical examination in a timely manner.

Drug therapy

Doctors prescribe drugs for the complex treatment of the disease.In the form of monotherapy, medicines are prescribed extremely rarely, since they help to reduce the production of growth hormone, but they cannot completely cure the disease.

Most often, drugs are prescribed in such cases:

if surgery has not yielded results,

if the patient refuses surgical intervention,

if there are contraindications for the operation.

Taking medications helps to reduce the tumor in size, so sometimes medication is prescribed before surgery.

For the treatment of acromegaly, drugs of the following groups are used:

somatostatin analogues (octreodite, lantreoditis),

growth hormone receptor blockers (pegvisomant).

Taking medications is carried out only as directed by a doctor. Self-medication, as well as folk remedies can aggravate the course of the disease.

Radiation therapy

Radiation therapy is rarely used in the treatment of acromegaly, because it has a frequent complication - the development of hypopituitarism. Complications may occur a few years after therapy. In addition, the result in most cases when using this method does not occur immediately.

The following methods of radiation therapy are currently used:

The use of radiation therapy is necessarily accompanied by medication.

The term acromegaly disease means that it is a disease that occurs in a person who has impaired growth hormone production, namely, manifestations of enhanced reproductive function of growth hormone after a period of maturation. As a result, the proportionality of the growth of the entire skeleton, internal organs and soft tissues of the body is violated (this is due to nitrogen retention in the body). Acromegaly is especially pronounced on the limbs of the body, face and entire head.

This disease occurs in both women and men after the completion of the growth period. The prevalence of the disease is from 45-70 people per one million people. A child’s body rarely affects this ailment. In rare cases, in growing children, this excess of growth hormone leads to a condition called gigantism. Such a change is characteristic definitely due to excessive weight gain and bone growth.

Since acromegaly is not very common, and the disease goes away gradually, it is not easy to identify this ailment in the early stages.

All this is caused not only due to a violation of growth hormone, but also a change in other gland health functions:

Dysfunction of the adrenal cortex.

Due to acromegaly, the metabolism is disturbed, which in most cases leads to diabetes mellitus and carries a huge danger to human life. But do not be upset, there are certain medical manipulations that can significantly alleviate symptoms and reduce the further development of acromegaly.

Symptoms of acromegaly are a slow and subtle manifestation of the clinical development of the disease. This ailment occurs due to hormonal imbalance by a change in appearance, as well as a deterioration in well-being. There are patients who have identified this diagnosis only after 10 years. The main complaints of patients is an increase in the auricles, nose, limbs of the arms and legs.

In developing an effective fight against the disease, there are two main consequences: malignant neoplasms and pathology of the cardiovascular system. There are four main methods of getting rid of this ailment:

Surgical method. Qualified doctors completely remove the tumors. This method allows you to quickly get the result. There are some complications after surgery.

Radiation therapy or radiation. Most often, this method is used in the case when surgical intervention did not help. Also, irradiation has some investigative flaws: the optic nerve is affected, a secondary brain tumor.

The medication method. Acromegaly is treated with the following three types of drugs:

Analogs of FTA (long-term (Samatulin and Sandostatin LAR) and short-acting - Sandostatin Octroedit).

Dopamine agonists (ergoline and nonergoline drugs).

Combined. Thanks to this method, the most positive treatment result is achieved.

But experience shows that doctors still adhere to medication. This method has a less negative effect on the human body.

A list of medications to combat the effects of acromegaly is sufficient:

Genfastat is a homeopathic remedy.

Octride is a mucolytic agent.

Sandotatin - Beta - Adrenergic blocker.

Samatulin is an antiseptic.

In most of these drugs, the active substance is octreodite. All dosages and treatment regimens are prescribed only by the attending physician.

What should be remembered when using folk remedies in the treatment of acromegaly

Useful to strengthen the body and speed up the healing process will be decoctions and teas prepared from plants and herbs such as:

licorice and ginseng root

Acromegaly, folk remedies for the treatment of which are used exclusively after agreement with the doctor, is quite amenable to relief. It must be remembered that infusions and teas from herbs should not be stored for a long period of time. They should be used within 24 hours after infusion and straining.

This is due to the fact that if they stand for a long time, they will lose all the healing, restorative characteristics and, even worse, they can cause significant harm. In the treatment of acromegaly with folk recipes, this is unacceptable, because any negative effect will affect the body and the activity of the thyroid gland, which is assigned one of the main roles in this case.

A mandatory step, which also needs to be coordinated with a specialist, is diet therapy. It allows you to strengthen the body, speed up metabolism and increase the degree of body resistance.

The most requested recipes

If you have acromegaly, folk recipes will help stop some of the symptoms of the disease. One of the most popular recipes is a mixture consisting of pumpkin seeds, primrose grass, grated root part of ginger, sesame seeds and 1 tsp. honey. The presented mixture must be used for 1 tsp. four times a day. If after 14-16 days there are no positive changes in the treatment process, it is necessary, after consultation with the endocrinologist, to adjust the composition or refuse to use this drug.

Recovery with acromegaly folk recipes involves the use of plant fees. The presented medicinal composition includes such ingredients as:

Mixing plants (at least 10 g.) Brewed in 200 ml. boiling water. To use the presented remedy is required for 40-50 ml. before eating and this must be done at least 4 times within 24 hours.

It should be noted that the use of folk remedies and recipes in the treatment of acromegaly is definitely useful. This is due to the positive effect on the endocrine gland. However, the main emphasis in the treatment of acromegaly should be done not only on prescriptions, but also on the use of medicines, surgical methods of recovery. With the correct combination of the presented methods, the result will be 100%.

What is acromegaly?

For the production of growth hormone, the part of the brain - the pituitary gland - is responsible. Normally, this hormone is produced in children from the first day of life, it is especially strongly activated during puberty, when the increase in growth can reach up to 10 cm in several months. After this stage is completed, somatotropin decreases its activity in this direction: growth zones close on average at 15-17 years for women and 20-22 for men.

Acromegaly - This is a pathological condition in which growth hormone continues to be actively produced in adults. There are cases when it starts to activate again in fully formed patients who were previously completely normal.

Growth hormone does not completely cease to be produced by the anterior pituitary gland in adults.

This hormone is maintained and normal, responsible for:

  • carbohydrate metabolism - protects the pancreas, monitors blood sugar,
  • fat metabolism - in combination with sex hormones regulates the distribution of subcutaneous fat,
  • water-salt metabolism - affects the activity of the kidneys, diuresis.

The pituitary gland "works" along with another part of the brain - hypothalamus. The latter is responsible for the secretion of somatoliberin, which encourages the addition of somatotropic production and somatostatin - respectively, inhibitory excess and not allowing excessive effects on human organs.

This balance can be individual depending on race, genetic factors, gender, age, and nutritional characteristics. Therefore, on average, faces of the European race are higher than representatives of Asian peoples, men have longer arms and legs than women, etc. All this is considered a variant of the norm.

When talking about acromegaly, it implies a pathological disorder of the functions of the hypothalamus and pituitary gland. There are many reasons, but the diagnosis can be made only by the results of analyzes, which include the level and time of secretion of growth hormone plus IRF I, an insulin-like growth factor.

Acromegaly is a disease of adults, previously healthy. If the symptoms increase from childhood, then the conditions are called gigantism.

Both pathologies not only significantly affect the appearance of a person. They cause a huge number of complicationsAmong which are exhaustion, a predisposition to the development of cancer of a certain type, and other serious consequences.

Timely diagnosis and treatment methods help control the disease, avoiding the long-term consequences for health and life. Measures should be taken at the first suspicion of endocrine diseases, in some cases, depending on the reasons, it will be possible to completely get rid of the symptoms.

Causes of Acromegaly

The general mechanism for the development of symptoms of acromegaly is the incorrect secretion of growth hormones, which provoke pathological proliferation of cells.

Among the immediate causes are the following:

  1. Benign tumors, as a rule, pituitary adenomas become the direct cause of acromegaly in more than 90% of cases. Child gigantism is also associated with the same pathology, because such neoplasms very often develop in a child at an early age or in a teenager with the onset of puberty.
  2. Tumors and other pathologies of the hypothalamus, which cause either a lack of a hormone that inhibits the secretion of growth hormone, or, conversely, cause the pituitary gland to produce an increased amount of the substance. This is the second most common cause of acromegaly.
  3. The immediate cause of the onset of the disease is very often injured in the skull, brain, including concussion. Displacement or damage occurs, resulting in cysts or tumors. A history of most adult patients suffering from acromegaly, head injury of moderate and severe severity.
  4. Enhanced production of IGF, which may also be associated with tumors, pathologies of the hormonal system, liver. The protein itself is produced by hepatocytes, but its content in the blood can be influenced by multiple factors - insulin, the content of testosterone and estrogen, and the activity of the thyroid gland.
  5. In rare cases, there is a phenomenon of ectopic secretion of growth hormone by other organs - the thyroid, ovaries, testicles. This is not a very common pathology, but also found in patients with acromegaly and gigantism.

You can identify the disease already at an early stagewhen minor changes begin. In an adult, the appearance changes quite quickly, forming a clinical picture characteristic of the disease. In the case of a child with suspected gigantism, a full examination of the child by an endocrinologist, neuropathologist and other specialists is necessary.

Acromegaly Treatment

Like all endocrine diseases, acromegaly is poorly treated. Therefore, early detection and diagnostic measures are important, which allow timely detection of pathology and prevent the occurrence of serious complications. Currently, a complete cure with the patient returning to the state before the disease considered rare, but measures can be taken to prevent further progression of the disease.

Therapeutic efficacy proved:

  1. Surgical intervention - removal of pituitary adenomas, tumors of the hypothalamus and other neoplasms in the brain that affect the production of growth hormone. Unfortunately, this method is not always suitable, sometimes the size of the tumor is very small, but it continues to affect the sensitive area of ​​the brain.
  2. Radiation therapy - comes to replace the operation, if there is no way to directly remove the tumor. Under the influence of special radiation, it is possible to effectively achieve regression of the neoplasm, its reduction. Cons of treatment: hard to tolerate by the patient, does not always have the desired effect.
  3. Reception STH secretion inhibitors, one of the specific drugs is Sandostatin. The selection of the drug should be carried out by the endocrinologist, as well as the dosage, the regimen of the drug.
  4. An important part of supporting patients with advanced acromegaly is painkillers, chondroprotectors and other agents that help reduce the manifestations of the disease.

With early diagnosis and the absence of serious complications, good results can be achieved, up to the patient's return to normal life. Additionally, patients are prescribed diabetes mellitus prophylaxis, high calorie diet recommended, which helps to provide the body with the necessary amount of nutrients, but a reduced amount of glucose and sugar, because the body's tolerance to this substance is impaired.

Causes of the disease

The main prerequisite for the development of acromegaly is a violation of the pituitary gland, which is expressed in excessive secretion of somatropin (growth hormone). At an early age, this hormone stimulates the growth of the skeleton of a child, and in adults it regulates carbohydrate and fat metabolism. With acromegaly, pituitary cells for various reasons actively proliferate without responding to body signals (this is caused in most cases by a tumorous disease).
The main causes of the development of the disease include:

  • Pituitary adenoma, which provokes increased secretion of the hormone somatropin.

  • Pathological changes in the frontal lobe of the hypothalamus.
  • Increased sensitivity of body tissues to growth hormone.
  • Heredity, the presence of a disease of samatotrophinomas.
  • The formation of cysts in the brain, the development of which can be triggered by a traumatic brain injury or an inflammatory disease.
  • The presence of tumors in the body.

Stages of Acromegaly Development

The disease goes through three degrees of disease development:

  • The early stage is preacromegalic. At this stage, there are no symptoms of the disease, so it is almost impossible to identify and can only be detected by chance during a general medical examination.
  • The hypertrophic stage is characterized by the first manifestations of symptoms, external changes in body parts. At this stage, the tumor grows in size and obvious signs appear: increased intracranial pressure, a sharp decrease in vision, general weakness of the body.
  • The cachectal stage is the last stage of the disease, at which depletion of the body is observed, various kinds of complications develop.

Disease prevention

In order to prevent the development of pituitary acromegaly, it is necessary to follow simple preventive measures:

  • Avoid craniocerebral or other head injuries.
  • Prevent the development of inflammatory diseases of the brain (for example, meningitis).
  • Periodically take laboratory tests for growth hormone in the blood.
  • Carefully monitor the health of the respiratory system and carry out their timely rehabilitation.

Acromegaly - photos, causes, first signs, symptoms and treatment of the disease

Acromegaly is a pathological syndrome that progresses due to overproduction by the pituitary gland of somatotropin after ossification of the epiphyseal cartilage. Often, acromegaly is confused with gigantism. But, if gigantism occurs from childhood, only adults suffer from acromegaly, and visual symptoms appear only 3-5 years after a malfunction in the body.

Acromegaly is a disease in which the production of growth hormone (growth hormone) increases, while there is a violation of the proportional growth of the skeleton and internal organs, in addition, there is a metabolic disorder.

Somatropin enhances the synthesis of protein structures, while performing the following functions:

  • slows down the breakdown of proteins,
  • accelerates the conversion of fat cells,
  • reduces the deposition of fatty tissue in the subcutaneous tissue,
  • increases the ratio between muscle mass and adipose tissue.

It is worth noting that the level of the hormone directly depends on age indicators, so the highest concentration of somatropin is observed in the first years of life up to about three years, and its maximum production occurs in adolescence. At night, somatotropin is significantly increased, so sleep disturbance leads to its decrease.

It happens that with diseases of the nervous system that affect the pituitary gland, or for some other reason, the body malfunctions and somatotropic hormone is produced in excess. In the base indicator, it is significantly increased. If this happened in adulthood, when active growth zones are already closed, this threatens with acromegaly.

In 95% of cases, the cause of acromegaly is a pituitary tumor - an adenoma, or somatotropinoma, which provides increased secretion of growth hormone, as well as its uneven entry into the blood

Acromegaly begins to develop after the cessation of body growth. Gradually, over a long period, symptoms increase, and changes in appearance occur. On average, acromegaly is diagnosed after 7 years from the actual onset of the disease.

As a rule, acromegaly develops after injuries of the central nervous system, its infectious and non-infectious inflammatory diseases. A certain role in development is assigned to heredity.

Acromegaly develops rather slowly, therefore its first symptoms often go unnoticed. Also, this feature is very difficult for the early diagnosis of pathology.

The photo shows a characteristic symptom of acromegaly on the face

Experts highlight the main symptoms of pituitary acromegaly:

  • frequent headache, usually due to increased intracranial pressure,
  • sleep disorders, fatigue,
  • photophobia, hearing loss,
  • occasional dizziness,
  • swelling of the upper limbs and face,
  • fatigue, decreased performance
  • pain in the back, joints, limitation of joint mobility, numbness of the limbs,
  • sweating

An increased level of growth hormone leads to a malfunction characteristic changes in patients with acromegaly:

  • Thickening of the tongue, salivary glands and larynx leads to a decrease in the timbre of the voice - it becomes more deaf, a hoarseness appears,
  • zygomatic bone enlargement
  • lower jaw
  • eyebrows
  • hypertrophy of the ears
  • nose
  • lips.

This makes facial features rougher.

The skeleton is deformed, there is an increase in the chest, an expansion of the intercostal spaces, the spine is bent. The growth of cartilage and connective tissue leads to limited mobility of the joints, their deformation, joint pain occurs.

Due to the increase in internal organs in size and volume, the patient’s muscle dystrophy increases, which leads to the appearance of weakness, fatigue, and a rapid decrease in working capacity. Hypertrophy of the heart muscle and heart failure progresses rapidly.

Acromegaly is characterized by a long, perennial course. Depending on the severity of symptoms in the development of acromegaly, there are several stages:

  1. Preacromegaly - is characterized by the earliest signs, it is detected quite rarely, since the symptoms are not very pronounced. But still, at this stage, it is possible to diagnose acromegaly with the help of computed tomography of the brain, as well as by the level of growth hormone in the blood,
  2. Hypertrophic stage - pronounced symptoms of acromegaly are observed.
  3. Tumor: it is characterized by symptoms of damage and impaired function of structures that are located nearby. This may be a violation of the function of the organs of vision or increased intracranial pressure.
  4. The last stage is the stage of cachexia, it is accompanied by exhaustion due to acromegaly.

Take all the necessary preventive medical examinations in time to help identify the disease at an early stage.

The danger of acromegaly in its complications, which are observed from almost all internal organs. Common complications:

  • nervous disorders
  • pathology of the endocrine system,
  • mastopathy
  • uterine fibroids,
  • polycystic ovary syndrome,
  • intestinal polyps
  • coronary artery disease
  • heart failure,
  • arterial hypertension.

As for the skin, such processes occur:

  • roughening of skin folds,
  • warts
  • seborrhea,
  • excessive sweating
  • hydradenitis.

If the first symptoms appear that indicate acromegaly, you should immediately contact a qualified doctor for a diagnosis and accurate diagnosis. Acromegaly is diagnosed on the basis of blood test data for the level of IRF-1 (somatomedin C). At normal values, a provocative test with a glucose load is recommended. For this, a patient with suspected acromegaly is sampled every 30 minutes 4 times a day.

To confirm the diagnosis and search for the causes:

  1. General analysis of blood and urine.
  2. Blood chemistry.
  3. Ultrasound of the thyroid gland, ovaries, uterus.
  4. X-ray of the skull and the region of the Turkish saddle (bone formation in the skull where the pituitary gland is located) - an increase in the size of the Turkish saddle or bypass is noted.
  5. CT scan of the pituitary gland and brain with mandatory contrast or MRI without contrast
  6. Ophthalmological examination (eye examination) - in patients there will be a decrease in visual acuity, restriction of visual fields.
  7. Comparative study of photographs of the patient over the past 3-5 years.

Sometimes doctors are forced to resort to surgical techniques for the treatment of acromegaly. Usually this happens if the formed tumor reaches too large sizes and compresses the surrounding brain tissue.

Conservative treatment for pituitary acromegaly consists in the use of drugs that inhibit the production of growth hormone. Nowadays, two groups of drugs are used for this.

  • One group - analogues of somatostin (Sandotastatin, Somatulin).
  • The second group is dopamine agonists (Parloder, Abergin).

If the adenoma has reached significant size, or if the disease is rapidly progressing, drug therapy alone will not be enough - in this case, the patient is shown surgical treatment. With extensive tumors, a two-stage operation is performed. At the same time, the part of the tumor located in the cranium is first removed, and after a few months, the remnants of the pituitary adenoma through the nose are removed.

A direct indication for surgery is a rapid loss of vision. The tumor is removed through the sphenoid bone. In 85% of patients, after removal of the tumor, a significant decrease in the level of growth hormone is noted up to the normalization of indicators and stable remission of the disease.

Radiation therapy of acromegaly is indicated only when surgical intervention is impossible and drug therapy is ineffective, because after it is carried out due to the delayed effect, remission occurs only after a few years, and the risk of developing radiation injuries is very high.

The prognosis for this pathology depends on the timeliness and accuracy of treatment. The absence of measures to eliminate acromegaly can lead to disability of patients of working and active age, and also increases the risk of mortality.

With acromegaly, life expectancy is reduced: 90% of patients do not live up to 60 years. Death usually occurs as a result of cardiovascular disease. The results of surgical treatment of acromegaly are better with small sizes of adenomas. With large tumors of the pituitary gland, the frequency of their relapses sharply increases.

Prevention of acromegaly is aimed at early detection of hormonal disruptions. If in time to normalize the increased secretion of growth hormone, you can avoid pathological changes in internal organs and appearance, cause persistent remission.

Prevention includes compliance with the following recommendations:

  • avoid traumatic head injuries,
  • consult a doctor for metabolic disorders,
  • carefully treat diseases that affect the organs of the respiratory system,
  • the nutrition of children and adults should be complete and contain all the necessary useful ingredients.

Acromegaly is a pituitary gland disease associated with increased production of growth hormone - somatotropin, characterized by increased growth of the skeleton and internal organs, enlargement of facial features and other parts of the body, and metabolic disorders. The disease makes its debut when the normal, physiological growth of the body is already completed. In the early stages, the pathological changes caused by it are subtle or not noticeable at all. Acromegaly progresses for a long time - its symptoms increase, and changes in appearance become obvious. On average, 5–7 years elapse from the onset of the first symptoms of the disease to diagnosis.

Persons of mature age suffer from acromegaly: as a rule, during the period of 40-60 years, both men and women.

Effects of somatotropin on human organs and tissues

The secretion of growth hormone - growth hormone - is carried out by the pituitary gland. It is regulated by the hypothalamus, which, if necessary, produces neurosecretions somatostatin (inhibits the production of growth hormone) and somatoliberin (activates it).

In the human body, growth hormone provides a linear growth of the skeleton of the child (i.e., its growth in length) and is responsible for the proper formation of the musculoskeletal system.

In adults, somatotropin is involved in metabolism - it has a pronounced anabolic effect, stimulates protein synthesis processes, helps to reduce the deposition of fat under the skin and enhances its combustion, increases the ratio of muscles to fat mass. In addition, this hormone also regulates carbohydrate metabolism, being one of the contra-hormonal hormones, i.e., increasing the level of glucose in the blood.

There is evidence that the effects of growth hormone are also immunostimulating and increased absorption of calcium by bone tissue.

The causes and mechanisms of acromegaly

In 95% of cases, the cause of acromegaly is a pituitary tumor - an adenoma, or somatotropinoma, which provides increased secretion of growth hormone. In addition, this disease can occur with:

  • pathology of the hypothalamus, provoking increased production of somatoliberin,
  • increased production of insulin-like growth factor,
  • hypersensitivity of tissues to growth hormone,
  • pathological secretion of growth hormone in the internal organs (ovaries, lungs, bronchi, organs of the gastrointestinal tract) - ectopic secretion.

As a rule, acromegaly develops after injuries of the central nervous system, its infectious and non-infectious inflammatory diseases.

It is proved that those who have this pathology also suffer from acromegaly more often.

Morphological changes in acromegaly are characterized by hypertrophy (increase in volume and mass) of tissues of internal organs, the growth of connective tissue in them - these changes increase the risk of developing benign and malignant neoplasms in the patient's body.

Subjective signs of this disease are:

  • enlargement of the hands, feet,
  • an increase in the size of individual facial features - large superciliary arches, nose, tongue (there are tooth imprints on it), enlarged protruding lower jaw, cracks appear between the teeth, skin folds on the forehead, nasolabial fold becomes deeper, the bite changes ,
  • voice coarsening
  • headaches,
  • paresthesia (a feeling of numbness, tingling, creeping creeps in various parts of the body),
  • pain in the back, joints, limitation of joint mobility,
  • sweating
  • swelling of the upper limbs and face,
  • fatigue, decreased performance
  • dizziness, vomiting (are signs of increased intracranial pressure with a substantial pituitary tumor),
  • numbness of the limbs
  • menstrual disorders
  • decreased sex drive and potency,
  • visual impairment (double vision, fear of bright light),
  • hearing loss and smell loss,
  • expiration of milk from the mammary glands - galactorrhea,
  • periodic pain in the heart.

An objective examination of a person suffering from acromegaly, the doctor will detect the following changes:

  • again, the doctor will pay attention to the enlargement of facial features and limb sizes,
  • deformations of the bone skeleton (curvature of the spine, barrel-shaped - increased in anteroposterior size - chest, extended intercostal spaces),
  • swelling of the face and hands,
  • sweating
  • hirsutism (enhanced male hair growth in women),
  • an increase in the size of the thyroid gland, heart, liver and other organs,
  • proximal myopathy (i.e., changes in the muscles located in relative proximity to the center of the trunk),
  • high blood pressure
  • measurements on an electrocardiogram (signs of the so-called acromegaloid heart),
  • elevated prolactin levels in the blood,
  • metabolic disorders (in a quarter of patients there are signs of diabetes mellitus, resistant (stable, insensitive) to hypoglycemic therapy, including the administration of insulin).

In 9 out of 10 patients with acromegaly in its developed stage, symptoms of night apnea syndrome are noted. The essence of this condition is that due to hypertrophy of the soft tissues of the upper respiratory tract and a malfunction of the respiratory center in humans, short-term respiratory arrest occurs during sleep.The patient himself, as a rule, does not suspect them, but the relatives and friends of the patient pay attention to this symptom. They note night snoring, which is interrupted by pauses, during which often the respiratory movements of the patient's chest are completely absent. These pauses last a few seconds, after which the patient suddenly wakes up. There are so many awakenings during the night that the patient does not get enough sleep, feels overwhelmed, his mood worsens, he becomes irritable. In addition, there is a risk of patient death if one of the respiratory arrests is delayed.

In the early stages of development, acromegaly does not cause discomfort to the patient - not very attentive patients do not even immediately notice an increase in one or another part of the body in size. As the disease progresses, the symptoms become more pronounced, in the end there are symptoms of heart, liver and pulmonary failure. In such patients, the risk of contracting atherosclerosis, hypertension is an order of magnitude higher than in individuals who do not suffer from acromegaly.

If the pituitary adenoma develops in a child when the growth areas of his skeleton are still open, they begin to grow rapidly - the disease manifests itself as gigantism.

Brief description of pathology

Acromegaly develops, as a rule, with tumor neoplasms localized in the anterior pituitary gland, responsible for the production of growth hormone. In patients suffering from this pathology, facial features change (become larger), hands and foot size increase. In addition, the pathological process is accompanied by painful joint and headaches, there are violations in the reproductive system.

Important! This disease, like acromegaly, affects only adult patients. Pathology begins to develop upon completion of puberty and growth of the body!

According to statistics, patients in the age category from 40 to 60 years are most affected by acromegaly. The pathological process is characterized by a gradual, slowed course. In most cases, the disease is diagnosed after 6-7 years from the beginning of its development, which significantly complicates the subsequent treatment.

Doctors distinguish the following stages of the development of the pathological process:

  1. At the first stage, the disease proceeds in a latent, latent form, and changes can only be detected by computed tomography of the brain.
  2. At this stage, the symptomatology characteristic of the pathology manifests itself especially clearly.
  3. In the third stage, there is an increase in the tumor neoplasm located in the anterior pituitary gland. At the same time, neighboring brain sections are compressed, which causes the manifestation of specific signs, such as visual impairment, nervous disorders, and an increase in intracranial pressure.
  4. The last fourth stage of acromegaly is characterized by the development of cachexia and complete depletion of the patient's body.

An increased concentration of growth hormone promotes the development of cardiovascular, pulmonary and oncological diseases, which often cause the death of patients suffering from acromegaly.

Prediction and prevention of acromegaly

Without treatment, the prognosis is poor, patients have a life span of three to five years, with congenital gigantism, people rarely survived to twenty before the appearance of topical drugs. Modern methods can inhibit the production of growth hormone or reduce the sensitivity of the body to it. Sometimes completely removes the tumorthat has become the root cause. Therefore, with the right therapy, the prognosis can be up to 30 years of life, but constant maintenance therapy is required. Most patients have limited disability.

Prevention of such rare and complex diseases is ambiguous, since there is no single reason for the occurrence of acromegaly. A recommendation from doctors can be advice avoid head injuries, and for those who have suffered a concussion, visit a neurologist and endocrinologist for several years after an accident, which will allow you to detect pathological changes in the pituitary gland at an early stage.

The mechanism of development and causes of acromegaly

The secretion of growth hormone (growth hormone, STH) is carried out by the pituitary gland. In childhood, growth hormone controls the formation of the musculoskeletal skeleton and linear growth, while in adults it controls the carbohydrate, fat, water-salt metabolism. The secretion of growth hormone is regulated by the hypothalamus, which produces special neurosecrets: somatoliberin (stimulates the production of GH) and somatostatin (inhibits the production of GH).

Normally, the somatotropin content in the blood fluctuates during the day, reaching its maximum in the morning hours. In patients with acromegaly, there is not only an increase in the concentration of STH in the blood, but also a violation of the normal rhythm of its secretion. For various reasons, cells of the anterior pituitary gland do not obey the regulatory influence of the hypothalamus and begin to multiply actively. The proliferation of pituitary cells leads to the appearance of a benign glandular tumor - pituitary adenoma, which intensively produces somatotropin. The size of the adenoma can reach several centimeters and exceed the size of the gland itself, squeezing and destroying normal pituitary cells.

In 45% of patients with acromegaly, pituitary tumors produce only somatotropin, another 30% additionally produce prolactin, in the remaining 25%, in addition, luteinizing, follicle-stimulating, thyroid-stimulating hormones, A subunit are secreted. In 99%, it is the pituitary adenoma that causes acromegaly. The factors causing the development of the pituitary adenoma are traumatic brain injuries, hypothalamic tumors, chronic sinus inflammation (sinusitis). A certain role in the development of acromegaly is assigned to heredity, since the disease is more often observed in relatives.

In childhood and adolescence, against the background of continued growth, chronic STH hypersecretion causes gigantism, characterized by an excessive, but relatively proportional increase in bones, organs and soft tissues. With the completion of physiological growth and ossification of the skeleton, disorders of the type of acromegaly develop - disproportionate thickening of bones, an increase in internal organs and characteristic metabolic disorders. With acromegaly, hypertrophy of the parenchyma and stroma of the internal organs: heart, lungs, pancreas, liver, spleen, intestines. The growth of connective tissue leads to sclerotic changes in these organs, the risk of developing benign and malignant tumors, including endocrine ones, increases.

Complications of Acromegaly

The course of acromegaly is accompanied by the development of complications from almost all organs. The most common in patients with acromegaly are heart hypertrophy, myocardial dystrophy, arterial hypertension, heart failure. More than a third of patients develop diabetes mellitus, liver dystrophy and pulmonary emphysema are observed.

Hyperproduction of growth factors with acromegaly leads to the development of tumors of various organs, both benign and malignant. Acromegaly is often accompanied by diffuse or nodular goiter, fibrocystic mastopathy, adenomatous adrenal hyperplasia, polycystic ovaries, uterine fibroids, intestinal polyposis. Developing pituitary insufficiency (panhypopituitarism) is due to compression and destruction of the pituitary gland tumor.

What is the pathology dangerous?

In addition to the fact that acromegaly itself spoils the patient’s appearance and significantly reduces the quality of his life, in the absence of proper treatment, this pathology can also provoke the development of extremely dangerous complications.

In most cases, a prolonged course of acromegaly leads to the appearance of the following concomitant diseases:

  • disorders of the gastrointestinal tract,
  • nervous disorders
  • pathology of the endocrine system,
  • adrenal hyperplasia
  • fibroids
  • intestinal polyps
  • infertility,
  • arthritis and arthrosis,
  • coronary artery disease
  • heart failure,
  • arterial hypertension.

Note:Almost half of patients with acromegaly have a complication such as diabetes mellitus.

Violations of the visual and auditory functions characteristic of this pathology can cause complete deafness and blindness of the patient. Moreover, these changes will be irreversible!

Acromegaly greatly increases the risks of the appearance of tumor malignant neoplasms, as well as various pathologies of the internal organs. Another life-threatening complication of acromegaly is respiratory arrest syndrome, which mainly occurs in a state of sleep.

That is why a patient who wants to save his life, when the first signs that indicate acromegaly appear, must seek professional help from a qualified specialist - an endocrinologist!

How to identify the disease?

In most cases, a specialist may suspect the presence of acromegaly already in the patient's appearance, characteristic symptoms and during the analysis of the collected history. However, to make an accurate diagnosis, determine the stage of the pathological process and the degree of damage to internal organs, patients are prescribed the following diagnostic tests:

Important! The main diagnostic method is the analysis of growth hormone using glucose. If the pituitary gland functions normally, glucose contributes to a decrease in growth hormone levels, otherwise the hormone level, on the contrary, increases.

To identify concomitant complications provoked by the development of acromegaly, such additional diagnostic measures are carried out:

After conducting a comprehensive diagnosis, the specialist can not only make an accurate diagnosis, but also identify the presence of concomitant diseases, which allows the patient to be assigned the most complete and appropriate therapeutic course for a particular case!

Acromegaly Treatment Methods

The main task of doctors in diagnosing acromegaly is to achieve stable remission, as well as normalize the processes of growth hormone production.

The following methods may be used for these purposes:

  • taking medications
  • radiation therapy,
  • surgery.

Important! In most cases, an effective fight against this disease requires complex combination therapy.

Conservative methods

To suppress excessively intense production of growth hormone, patients are prescribed a course of hormone therapy using artificial somatostatin analogues. Often patients are also prescribed a drug such as Bromocriptine, aimed at producing dopamine, which suppresses the synthesis of the hormone somatotropin.

In the presence of characteristic complications and concomitant diseases, appropriate symptomatic treatment is carried out, a scheme of which is developed for each patient individually.

The use of radiation therapy has shown good results.. This procedure is the impact on the damaged area of ​​the pituitary gland by specific gamma rays. According to statistics and clinical trials, the effectiveness of this technique is about 80%!

One of the most modern ways of conservatively controlling acromegaly is radiotherapy. According to experts, the effect of x-ray waves contributes to the active suppression of the growth of tumor neoplasms and the production of growth hormone. A full course of x-ray therapy allows you to achieve stabilization of the patient's condition and eliminate symptoms characteristic of acromegaly, even the facial features of the patient are slightly flattened!

Surgical Acromegaly Treatment

Surgical intervention for acromegaly is indicated for significant sizes of tumor neoplasms, rapid progression of the pathological process, as well as in the absence of the effectiveness of conservative therapy methods.

Important! Surgery is one of the most effective methods of controlling acromegaly. According to statistics, 30% of the operated patients were completely cured of diseases, and in 70% of patients there is a persistent, long-term remission!

Surgical intervention for acromegaly is an operation aimed at removing the pituitary tumor neoplasm. In especially difficult cases, a second operation or an additional course of drug therapy may be required.

How to prevent pathology?

In order to prevent the development of acromegaly, doctors advise to adhere to the following recommendations.

  • avoid traumatic head injuries,
  • treat infectious diseases in a timely manner,
  • consult a doctor for metabolic disorders,
  • carefully treat diseases that affect the organs of the respiratory system,
  • periodically take tests for growth hormone indicators for prophylactic purposes.

Acromegaly is a rare and dangerous disease, fraught with a number of complications. However, timely diagnosis and competent, adequate treatment can achieve a stable remission and return the patient to a full, familiar life!

Sovinskaya Elena, medical observer

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Watch the video: Pituitary Tumors - Mayo Clinic (April 2020).