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General Medicine

Acromegaly

Julie A Creech, DO, CAQSM and Nicholas Wayne Ginther, MD Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Acromegaly: a rare endocrinologic disease characterized by excess secretion of growth hormone (GH), resulting in a syndrome of coarsened facial features and overgrowth of the jaw, ha...

DIAGNOSIS

HISTORY

  • Musculoskeletal

    • Enlarging shoe and ring size

    • Arthralgias/myalgias

  • Neurologic

    • Headache

    • Vision changes, particularly temporal hemianopsia

    • Hand numbness/carpal tunnel syndrome

    • Fatigue, weakness

    • ...

TREATMENT

  • Goals of treatment:

    • Decrease the serum IGF-1 level to within the reference range for the patient's age and sex.

    • Lower serum GH to <1 mcg/L

    • Ameliorate symptoms without causing other pituitary...

ONGOING CARE

Following successful resection with normalization of IGF-1 levels, patients should continue to be monitored for recurrence. Regular appointments with endocrinology and neurosurgical speci...

REFERENCES

1
Fleseriu M, Biller BMK, Freda PU, et al. A Pituitary Society update to acromegaly management guidelines. Pituitary. 2021;24(1):1-13. doi:10.1007/s11102-020-01091-7
2
Ogedegbe OJ, Yar Cheema ...

SEE ALSO

Algorithm: Tall Stature 

CODES

ICD10

E22.0 Acromegaly and pituitary gigantism 

SNOMED

  • 74107003 Acromegaly (disorder)

  • 240089002 Myopathy in acromegaly (disorder)

  • 230581008 Neuropathy in acromegaly (disorder)

  • 80849007 Gigantism (diso...

CLINICAL PEARLS

  • The onset of acromegaly is insidious and may be initially subtle.

  • The serum IGF-1 level is the preferred screening test and is elevated in acromegaly. An elevated IGF-1 should prompt an...

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The clinical manifestations of acromegaly.

 

The clinical manifestations of acromegaly.

 

Acromegaly is characterized by enlargement of the facial features (nose, ears) and the hands and feet.

 

Acromegaly is characterized by enlargement of the facial features (nose, ears) and the hands and feet.

 
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