ACROMEGALY, is a chronic disease occurring in middle life. It is characterized by inereased secretion of growth hormone by the front region of the pituitary gland and enlargement of parts of the head, hands, and feet.
Cause and Characteristics.
The pituitary gland contains several kinds of cells that secrete different hormones. In acromegaly there is an inerease in the number of growth hormone-secreting cells. This inerease in celi number usually produces a pituitary tumor, which may press on the optic nerves and interfere with vision.
The excessive secretion of growth hormone causes many abnormalities. The most obvious changes are in certain soft tissues, cartilage, and bones. These changes give a characteristic burly, large-jawed appearance to patients with the disease. The skin of the face is puffy, and the facial lines are exaggerated. The nose and ears enlarge; the larynx is big, and the voice is husky. The jawbone lengthens and protrudes forward. Because the rib cartilages lengthen, the ehest cage becomes barrel-like. Bony overgrowth in the spine causes difficulty in bending forward and also causes arthritis. Less obvious abnormalities are inereased hairiness, sweating, enlargement of the thyroid gland, diabetes, and sometimes high blood pressure.
Acromegaly is usually benign and lasts many years. (Rarely, there is bleeding into the pituitary tumor, which requires quick surgical intervention.) Patients sometimes have bother-some symptoms in various areas: severe headaches; tingling and numbness in hands and feet; back, hip, or knee pain due to arthritis; or severe weakness and wasting of museles. Except for the change in appearance, most patients tolerate the disease well and are relatively healthy. The major complications are due to diabetes or high blood pressure, when they exist. Occasionally, remaining pituitary tissue is destroyed by the tumor, causing failure of the glands that are dependent upon the pituitary.
X-ray treatment of the pituitary region is the most commonly used method. In most cases, this treatment stops the growth of the tumor and, in some cases, reduces the excessive growth hormone secretion. If visual damage is sudden or great, surgery may be necessary to remove the tumor. Newer, experimental methods are destruction of the pituitary tumor by liquid nitrogen or direct insertion of radioactive materials into the pituitary gland.