Acromegaly

Acromegaly is a hormonal disorder characterised by abnormal bone growth, enlarged hands and feet, and thickened, enlarged face.1 Learn more about this rare endocrine disease, its diagnosis and the different treatment options available.

 

Definition

Acromegaly is a hormonal condition in which the body produces too much growth hormone, leading to the excess growth of body tissues over time. The characteristic symptoms of acromegaly are abnormally large hands and feet, and changes in facial features.1

Growth hormone is produced and released by the pituitary gland, a small gland just below the brain. When growth hormone is released into the blood, it stimulates the liver to produce another hormone – insulin-like growth factor 1 (IGF-1) – which causes growth of muscle, bones and cartilage throughout the body.1 This process is essential for growth and repair of body tissues.2

The excess growth hormone section in acromegaly usually occurs as the result of a benign (non-cancerous) brain tumour in the pituitary gland called an adenoma.

 

Symptoms and impact on health

The symptoms associated with acromegaly are caused by the excess growth hormone. The signs and symptoms appear very gradually and are often not apparent for several years.2
Symptoms caused by excess growth hormone:

  • Gradual changes to the face and extremities (hands and feet): shoe size increases and the person may find it difficult to take off rings. Greatly enlarged face, with thick nose and lips is a feature. The brows, cheekbones and chin protrude; the teeth space out and the voice becomes husky and deep.
  • Onset of carpal tunnel syndrome with symptoms ranging from tingling and numbness in the hands to pain
  • Pronounced fatigue.
  • Snoring and sleep apnoea
  • Diabetes mellitus
  • High blood pressure. This develops in about one in three people.
  • Cardiovascular disease and heart enlargement (cardiomegaly)
  • Enlarged liver, kidneys, spleen and other organs.
  • Arthritis due to the overgrowth of bone and cartilage. It can become difficult to write, tie shoe laces and perform other daily tasks.
  • People with acromegaly have an increased chance of developing small benign growths (polyps) in the bowel and a slightly increased chance of developing bowel cancer.1,2,3,4

In some cases the tumour grows enough to press on the nearby tissues inside the skull. This can lead to:

  • Headaches caused by the size of the tumour are frequent
  • Problems with vision caused by compression of the visual pathways
  • Other normal cells in the pituitary gland may become squashed and damaged. As a result, the pituitary gland may stop being able to produce some other hormones.1,2,3,4

 

Risk factors

There are no known risk factors or preventive measures against acromegaly. It is not known why the adenoma develops. In rare cases someone who develops acromegaly is related to someone else who has it. When this happens, the cause is genetic.2

 

Prevalence

Acromegaly is rare. About two to four people in a million develop acromegaly each year in the UK. It mainly develops in adults who are middle-aged (average age 40 years). Men and women are equally affected.2
Rarely, it affects children. If it develops in a child (it usually occurs between the ages of 15 to 17 years), it causes the condition called gigantism.2

2 to 42

New cases of acromegaly per year per million population.

40 years

Average age of diagnosis2

Sources :

1 Acromegaly – NHS Choices [Internet]. Nhs.uk. [cited 18 January 2017]. Available from: http://www.nhs.uk/conditions/acromegaly/Pages/Introduction.aspx Last accessed 18/07/2017
2 Acromegaly. Growth Hormone disorders Information; Symptoms | Patient [Internet]. Patient. [cited 18 January 2017]. Available from: http://patient.info/health/acromegaly-leaflet Last accessed 18/07/2017
3 What is Acromegaly? [Internet]. Acromegaly.org. [cited 18 January 2017]. Available from: https://acromegaly.org/en/23-what-is-acromegaly. Last accessed 18/07/2017.
4 Symptoms and causes – Acromegaly – Mayo Clinic [Internet]. Mayoclinic.org. [cited 18 January 2017]. Available from: http://www.mayoclinic.org/diseases-conditions/acromegaly/symptoms-causes/dxc-20177626 Last accessed 18/07/2017

Adverse events should be reported. Reporting forms and information can be found at wwww.mhra.gov.uk/yellowcard

Adverse events should also be reported to the Ipsen Medical Information Department on 01753627777 or medical.information.uk@ipsen.com

Date of preparation January 2018 / ALL-UK-000455