The acromegaly It is a rare disorder in adults that causes excessive growth of bones, organs and soft tissues, due to excess growth hormone. The most common origin of acromegaly is a benign tumor (an adenoma) in the pituitary gland (hypophysis), located at the base of the brain.
This tumor stimulates the excessive production of growth hormone (GH), which in turn induces the liver to generate high levels of the factor IGF-1, responsible for the abnormal growth of tissues and bones. Rarely, acromegaly may be due to tumors in other parts of the body (lung, pancreas…), which indirectly induce an excess of stimulating hormones.
Physical changes usually appear slowly, so they often go unnoticed at first, clarifies the Mayo Clinic. One of the most characteristic features is the enlargement of hands and feet (for example, rings no longer fit or a higher shoe size is needed), as well as changes in facial features: thicker lips and ears, wide nose, prominent jaw, enlarged forehead, and separation between the teeth.
The skin may become more thick, greasy or rough; Acne or skin tags may appear. Other signs include excessive sweating, enlarged organs (such as the heart), fatigue, joint pain, voice changesheadache and even vision problems if the tumor presses on nearby structures.
To diagnose acromegaly, specialists combine a medical history, physical examination and hormonal tests, mainly by measuring IGF-1 levels. If this is high, a growth hormone suppression test may be requested: after administering glucose, GH levels should decrease in a healthy person; in acromegaly, they remain elevated.
If hormonal tests suggest acromegaly, a MRI (or other imaging study) of the hypothalamic-pituitary area to locate the adenoma. X-rays of the hands and feet may also be done to evaluate for structural bone growth.
The objective of the treatment is to reduce the levels of growth hormone and IGF-1, eliminate or control the tumor and prevent or treat associated complications, states the Clínica Universidad de Navarra:
- Surgery: The most recommended option is usually removal of the adenoma through transsphenoidal surgery. This method manages in many cases to return hormonal levels to normal ranges.
- Pharmacological treatment: When surgery is not enough or cannot be performed, medications such as somatostatin analogues or dopamine agonists are used, which reduce the production of growth hormone. Another drug, the GH receptor antagonist, blocks its action on tissues.
- Radiotherapy: In those cases in which neither surgery nor drugs adequately control hormonal excess, traditional radiotherapy, stereotactic radiosurgery or proton therapy can be used. This option is usually slower to show results and requires prolonged follow-up.
If left untreated, acromegaly can lead to serious complications: hypertension, heart problems (cardiomyopathies, arrhythmias, valvular diseases), metabolic disorders such as diabetes or dyslipidemia, joint problems, sleep apnea, carpal tunnel syndrome, and even an increased risk of certain cancers.
Therefore, it is essential that anyone who detects progressive physical changes or symptoms such as excessive sweating, joint pain, fatigue or sleep problems consults an endocrinologist as soon as possible. An early diagnosis increases the chances of treating the disease successfully and avoiding serious sequelae.
