(See Presentation .) Growth hormone and insulinlike growth factor GH is necessary for normal linear growth. [emedicine.medscape.com]

Raynaud's disease is present in one-third of cases. [ncbi.nlm.nih.gov]

• Galactorrhea

  […] and pedunculated fibromas (ie, skin tags) Hypertrichosis Oily skin (acne is not common) Hyperpigmentation (40% of patients) Acanthosis nigricans (a small percentage of patients) Excessive eccrine and apocrine sweating Breast tissue becoming atrophic; galactorrhea [emedicine.medscape.com]

• Hodgkin Lymphoma

  Acromegaly caused by secretion of growth hormone by a non-Hodgkin's lymphoma. N Engl J Med. 2000; 342 :1871–6. doi: 10.1056/NEJM200006223422504. [ PubMed ] [ CrossRef ] [ Google Scholar ] Seth J, Ellis A, Al-Sadie R. [ncbi.nlm.nih.gov]

• Overeating

  This latter gene (a securin homolog) is over-expressed in functional pituitary tumors, which could lead to aneuploidy [ 45 ]; the degree of over-expression correlates with tumor size and invasiveness. [ncbi.nlm.nih.gov]

  Hyperhidrosis Osteoarthritis (a late feature of IGF-I excess) Peripheral neuropathies (eg, carpel tunnel syndrome) Cardiovascular disease Benign tumors Endocrinopathies Acromegaly Signs and symptoms of acromegaly include the following: Doughy-feeling skin over [emedicine.medscape.com]

• Hypertension

  widely spaced teeth, bone proliferation in extremities, soft tissue thickening, hyperhidrosis, macroglossia, headache, amenorrhoea, impotence, somnolence, moodiness, glucose intolerance, cardiomegaly with heart failure (acromegalic heart disease), hypertension [medical-dictionary.thefreedictionary.com]

  Insulin resistance and diabetes may also play a role in the onset of hypertension [ 20, 21 ]. Sleep apnea syndrome is likely to contribute also to the pathogenesis of hypertension. [ncbi.nlm.nih.gov]

  Efficacy of 12-month treatment with the GH receptor antagonist pegvisomant in patients with acromegaly resistant to long-term, high-dose somatostatin analog treatment: effect on IGF-I levels, tumor mass, hypertension and glucose tolerance. [medigraphic.com]

  […] necessarily correct the disorder Cardiovascular complications A study by Berg et al found an increased prevalence of cardiovascular risk factors in patients with acromegaly compared with controls. [1] Cardiovascular complications include the following: Hypertension [emedicine.medscape.com]

• Hypertrichosis

  Enlargement of the lower lip and nose (the nose takes on a triangular configuration) Wide spacing of the teeth and prognathism Cutis verticis gyrata (ie, furrows resembling gyri of the scalp) [6] Small sessile and pedunculated fibromas (ie, skin tags) Hypertrichosis [emedicine.medscape.com]

• Skin Thickening

  Skin changes Nearly 70% of patients have sweaty, oily skin. Skin thickening is due to glycosaminoglycan deposition and to increased collagen production by connective tissue. Skin tags are frequent and may be a marker of colonic polyps. [ncbi.nlm.nih.gov]

• Arthralgia

  The arthralgia is mainly mechanical, degenerative, non-inflammatory in origin but features of osteoarthritis may develop in some patients. Joint mobility (especially of the shoulders) can be limited in the later stages of the disease. [ncbi.nlm.nih.gov]

• Amenorrhea

  A gonadotrope deficiency will cause sexual dysfunction and decreased plasma testosterone levels in men, and menstrual disorders in women (amenorrhea in some cases) together with a decline in estradiol levels (without rise in gonadotrophin levels). [ncbi.nlm.nih.gov]

(See Presentation and Workup .) Robert Wadlow, 19 years of age, with his father (postcard photo prior to 1937). Courtesy of Wikimedia Commons (https://commons.wikimedia.org/wiki/File:Robert_Wadlow_postcard.jpg). [emedicine.medscape.com]

Effect of different dopaminergic agents in the treatment of acromegaly. J Clin Endocrinol Metab 1997;82:518-23. Abs R, Verhelst J, Maiter D, et al. Cabergoline in the treatment of acromegaly: a study in 64 patients. [medigraphic.com]

Currently, if surgical treatment fails to cure acromegaly, medical treatment with somatostatin analogs is recommended rather than radiotherapy. [ncbi.nlm.nih.gov]

(See Prognosis, Treatment, and Medication .) [emedicine.medscape.com]

It contains information on symptoms, proper testing, how to get a diagnosis, and the treatment options that are available. It also includes Pituitary Network Association's patient resource listings for expert medical care. [pituitary.org]

(See Prognosis, Treatment, and Medication .) [emedicine.medscape.com]

High GH/IGF-I concentrations, arterial hypertension, and cardiomyopathy are factors in a poor prognosis, while the duration of symptoms and other factors (diabetes, lipid disorders and cancer) are less important [ 30 ]. [ncbi.nlm.nih.gov]

(See Pathophysiology and Etiology .) GH acts indirectly, by stimulating the formation of IGF hormones (also called somatomedins). [emedicine.medscape.com]

Etiology [ 34, 35 ] Acromegaly of pituitary origin More than 95% of patients with acromegaly have a benign monoclonal pituitary adenoma which develops from the somatotrope cells that normally produce GH in the pituitary. [ncbi.nlm.nih.gov]

Epidemiology, clinical characteristics, outcome, morbidity and mortality in acromegaly based on the Spanish Acromegaly Registry. European Journal of Endocrinology 2004;151:439-46. Philippe C and Sylvie S. Acromegaly Orphanet. [medigraphic.com]

Systemic complications of acromegaly: epidemiology, pathogenesis, and management. [ncbi.nlm.nih.gov]

Epidemiology Gigantism is extremely rare, with approximately 100 reported cases to date. [emedicine.medscape.com]

(See Pathophysiology and Etiology .) GH acts indirectly, by stimulating the formation of IGF hormones (also called somatomedins). [emedicine.medscape.com]

Author Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, Rutgers New Jersey Medical School; Visiting Professor, Rutgers University School of Public [emedicine.medscape.com]

Treatment is aimed at correcting (or preventing) tumor compression by excising the disease-causing lesion, and at reducing GH and IGF-I levels to normal values. Transsphenoidal surgery is often the first-line treatment. [ncbi.nlm.nih.gov]