"At this time we have drugs with different mechanisms of action that allow, separately or in combination, control the disease in almost 100% of patients".
DR. CAMILO SILVA FROJÁN
SPECIALIST. ENDOCRINOLOGY AND NUTRITION DEPARTMENT
What is acromegaly?
Acromegaly is a rare endocrine disease due to excess production of growth hormone (GH) in the pituitary gland.
The pituitary gland is an endocrine gland, located at the base of the brain, which controls, produces, and secretes several hormones, including growth hormone.
Generally, growth hormone increase is related to the development of a benign tumor in the pituitary gland.
Acromegaly is one of the so-called "rare diseases". Most cases occur in middle-aged people and are usually diagnosed 10 to 15 years after the onset of symptoms, because the symptoms are slow and progressive.
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What are the symptoms of acromegaly?
The patient with acromegaly usually has an enlarged hand and foot, thick lips, altered facial features, enlarged jaw and forehead, and widely spaced teeth.
The most common symptoms of acromegaly are:
- Enlarged hands and feet
- Alteration of facial features
- Spaced teeth
- Enlargement of the heart
Apart from the changes in the physiognomy, headache is very common, and if the pituitary tumor is large, it can compress the optical pathways and cause visual difficulties.
It is frequent that high blood pressure, elevation of cholesterol, glucose in blood or diabetes mellitus appear. Cardiac arrhythmias or alterations in the functioning of the heart valves may also occur.
Do you have any of these symptoms?
You may suffer from acromegaly
What are the causes of acromegaly?
Acromegaly occurs when the body produces too much growth hormone. The source of the excess hormone is almost always the pituitary gland.
In adults, a tumor is the most common cause of excess growth hormone:
- Pituitary tumors. Most cases of acromegaly are caused by a non-cancerous (benign) tumor, or adenoma, of the pituitary gland. These tumors can put pressure on nearby tissues as they grow. This pressure can cause some of the symptoms of acromegaly, such as headaches and vision problems.
- Non-pituitary tumors. In some people, acromegaly is caused by benign or cancerous tumors in other parts of the body, such as the lungs, pancreas, or adrenal glands.
How is acromegaly diagnosed?
Delayed diagnosis of acromegaly can lead to "serious" complications in patients. Sometimes, the symptoms are identified with normal changes in aging, thus favoring its under-diagnosis.
To reach a diagnosis, a thorough medical history and physical examination is essential, as well as an analysis consisting of insulin-like growth factor-I (IGF-I) or somatomedin-C levels and basal growth hormone levels.
After analytical confirmation of excess growth hormone (GH), a magnetic resonance imaging (MRI) scan of the hypothalamic-pituitary area should be performed to confirm the origin of the excess GH.
Excess production of growth hormone in children is called gigantism, a very rare disorder.
How is acromegaly treated?
The aims are to normalize hormone levels, remove the tumor and treat complications
The initial treatment should consist of surgery, since this is the method that offers the best cure rates. The surgical approach depends on the situation of each patient and the extent of the tumor lesion.
The drug therapy of choice, for tolerance and effectiveness, are the somatostatin analogues. Currently, we have drugs with different mechanisms of action that allow, separately or in combination, to control the disease.
Radiotherapy is reserved for patients with persistent hormonal hypersecretion after surgery, and resistant or intolerant to the different drugs available.
Where do we treat it?
IN NAVARRE AND MADRID
The Department of Endocrinology and Nutrition of the
of the Clínica Universidad de Navarra
The Department is organized into care units with specialists totally dedicated to the study, diagnosis and treatment of this type of disease.
We work with established protocols, which ensure that all diagnostic tests to be performed are done in the shortest time possible and that the most appropriate treatment is started as soon as possible in each case.
Organized in care units
- Obesity Area.
- Diabetes Unit.
- Thyroid and Parathyroid Disease Unit.
- Osteoporosis Unit
- Other diseases: e.g. Cushing's syndrome.
Why at the Clinica?
- European Center of Excellence in the diagnosis and treatment of Obesity.
- Team of specialized nurses at the Day Hospital of Endocrinology and Nutrition.
- We have a Metabolic Research Laboratory of international prestige.