Acromegaly

June 21, 2011

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Acromegaly   - A disease known since ancient times and is characterized by an abnormal increase in any parts of the body, which is associated with increased production growth hormone , Also called growth hormone. The disease occurs most often after the growth of the organism in 20-40 years in both sexes and is manifested in the increase of the hands and feet, exaggerated increase in facial features. Symptoms of acromegaly occur constant headaches and joint pain, reproductive dysfunction. Very often, it increases the level of growth hormone in the blood contributes to the emergence of severe cardiovascular, pulmonary and cancer diseases and early death.

This is a rare disease, and it is diagnosed in 40 people out of a million, it begins quietly and gradually proceeds, and becomes noticeable approximately 7 years after occurrence.

Reasons and mechanism of the disease acromegaly

STH growth   It is produced in the pituitary gland, endocrine gland located at the base of the brain. This hormone is responsible for the child's growth process, the formation of muscles and skeleton. In adults, it provides control of metabolism, including on water-salt, carbohydrate and fat balance.

Control of pituitary function is carried from another part of the brain called the hypothalamus Which produces substances that stimulate or hindering the work of the pituitary gland.

In a healthy person the contents of growth hormone varies throughout the day, climbs alternate with decline. For several reasons, the pituitary cells fall out of the control of the hypothalamus and are beginning to multiply. Disturbed rhythm of hormone secretion and increased blood levels. Continuing a long time growth of these cells leads to the formation of " pituitary adenoma "- Benign tumors, reaching the size of a few centimeters. The tumor begins to compress the pituitary gland, sometimes destroying healthy cells. This tumor is the reason why there is acromegaly.

Other indirect causes acromegaly is unfavorable for pregnancy, tumors of the central nervous system, mental or cranial trauma, chronic infections - flu . measles   et al. A role in the development of inheritance withdrawn.

Stage acromegaly

The disease occurs in four stages, each of which is characterized by certain processes.

• In the initial preakromegalicheskoy stage   signs are very weak and are rarely detected. Diagnosis is possible only according to computed tomography of the brain and the indicators of the level of growth hormone in the blood.
• On hypertrophic stage   Symptoms of acromegaly pronounced.
• On tumor stage   symptoms of compression adjacent to a tumor of the brain. Increased intracranial pressure appeared nervous and ocular disorders.
• Stage cachexia   - The last phase of the disease, is characterized by exhaustion due to acromegaly.

Symptoms of acromegaly

Excess levels of growth hormone in the blood causes a change in the patient's appearance: increased eyebrows, cheek bones, the lower jaw, lips, nose, ears. Hypertrophy of the larynx, tongue, vocal cords causes a change in the voice. Significantly increases the size of the skull, hands, feet.

Deformed skeleton is an increase in chest expansion of intercostal spaces, curved spine. The growth of cartilage and connective tissue leads to the limited mobility of the joints, their deformation, joint pain occur.

Leather patients compacted. Salo- increases and sweating. The excessive increase in the internal organs and causes muscle degeneration of muscle fibers. The patient complains of fatigue, weakness, decreased performance, thirst . frequent urination , A sharp rise in temperature. Develops myocardial hypertrophy It is developing into heart failure. In 90% of patients, due to hypertrophy of the upper airways and disruption of the respiratory center, develops and snoring obstructive sleep apnea   in a dream.

With the growing pituitary tumor increases intracranial pressure, "headaches, dizziness . double vision , Photophobia, hearing loss, numbness, vomiting often occurs. Patients women disrupted menstrual cycle occurs infertility It appears galactorrhoea (release of milk from the mammary glands in the absence of pregnancy). In men, sexual dies potency .

Perhaps the development of diabetes insipidus, uterus, gastrointestinal tract, thyroid gland.

Diagnosis of acromegaly

Determined by the level of growth hormone in the blood on the basis of glucose tolerance test . Determined initial value STG And then after administration of glucose - four dough every half hour. If OK, after receiving the glucose level of GH should decrease, acromegaly active phase, it rises. This test is also used to assess the effectiveness of the therapy, but it can help to assign adequate treatment of acromegaly.

Determined by the concentration in the blood plasma insulin-like growth factors (IGF) , Increase indicates the development of acromegaly. Radiography of the skull bones to identify enlargement of sella, magnetic resonance and computer diagnostics. Ophthalmologic examination acromegaly reveals narrowing of the visual field.

Among other things, patients are screened to identify acromegaly complications due to the presence of diabetes, intestinal polyposis, thyroid disease and so on.

Treatment of acromegaly

Treatment of the disease consists of medical, surgical, radiation and combined techniques and is aimed at reducing the concentration of growth hormone, elimination of its normalization of hypersecretion and the concentration of IGF I. In result of treatment should be significantly reduced or completely disappear manifestations of the disease.

Assigned to receive analogue somatostatin Suppressing the secretion of growth hormone (lanreotide, Octreotide . Sandostatin . Somatulinom ). Subsequently, it appointed disposable ray or gamma-therapy of the pituitary region. Pituitary tumors removed surgically. The efficiency of the operation is 85% of patients with small tumors, and 30% with significant. In this case it is possible re-operation.

Prediction of treatment depends on the duration of the disease. If untreated, in severe patient's life expectancy is about 3-4 years old, with slow development from 10 to 30 years. Timely diagnosis of acromegaly and timely initiation of treatment gives a favorable prognosis, perhaps a full recovery.