acromegaly or gigantism

bila sebut pasal gigantism,teringat zaman sekolah diri,ada sorang budak ni tinggi sangat,and ena pernah dgr budak laki panggil dia giant=(.Ala takat ketinggian dia tu,bila dia p overseas,orang akan tgk normal je=(

kaki besar

acromegaly or gigantism berlaku disebabkan excess growth hormone dalam badan.hal ini berlaku disebabkan oleh:

• tumour of hypothalamus(increase GHRH secretion)
• pituitary adenoma(increaseGH)
• ectopic GH(small lung ca produce GH)

apabila GH terlebih didalam badan,hal ini akan menyebabkan increase in growth of bone and soft tissues.plus,GH also influence the metabolic effect

increase in growth of bone and soft tissues

• enlarged hand and feet
• frontal bossing(prominen supraorbital ridge)
• organomegaly(liver,heart,spleen,thyroid,kidney,colon)
• progantism(protrusion of the jaw,and spacing between teeth,lead to difficulty in chewing)
• enlarged nose,tongue and lips
• skin tags at the armpit
• carpal tunnel syndrome(proliferation of the soft tissue compress the nerve->numbness)

metabolic effects

GH is anti insulin hormone.it promotes protein synthesis,increase fatty acid utilisation and also gluconeogenesis.therefore,it will cause GH induced insulin tolerance

• increase glucose level(DM)
• use ketone as sourceofenergy(diabetic ketoacidosis)
• hypertension

hyperprolactinemia

increase GH will cause increase prolactin.high prolactin will cause:

• gynaecomastia
• impotence,loss of libido.amenorrhoea(inhibit FSH and LH secretion)

pituitary adenoma compress the optic chiasm cause bitemporal hemianopia.increase intracranial pressure cause headache.also obstruct the CSF,edema of optic dics,lead to papilloedema.

investigation

• GH level after giving OGTT(GH release in a pulsatile manner)
• IGF-1 level
• MRI

treatment

• surgery(remove the tumor)
• radiation(less effective)
• dopamine agonist(bromocriptine)-prolactin inhibitor
• somatostatine(octreotide)-reduce GH

p/s:http://odelrio.blogspot.com/
(blog seorang pesakit acromegaly,let's support them=p)

"selamat belajar"