Acromegaly can be an insidious disease. Symptoms, which may precede diagnosis by several years, can be divided into the following groups:
Symptoms due to local mass effects of an intracranial tumor
Symptoms due to excess of GH/IGF-I
Symptoms due to local mass effects of tumor depend on the size of the intracranial tumor. Headaches and visual field defects are the most common symptoms. Different visual field defects manifest depending on which part of the optic nerve pathway is compressed. The most common manifestation is a bitemporal hemianopsia caused by pressure on the optic chiasm.
Tumor damage to the pituitary stalk may cause hyperprolactinemia due to loss of inhibitory regulation of prolactin secretion by the hypothalamus. Some growth hormone-secreting tumors may co-secrete prolactin. Damage to normal pituitary tissue can cause deficiencies of glucocorticoids, sex steroids, and thyroid hormone. Loss of end-organ hormones results from diminished anterior pituitary secretion of corticotropin.
Symptoms due to excess of GH/IGF-I include:
Soft tissue swelling and enlargement of extremities
Increase in ring and/or shoe size
Hyperhidrosis
Coarsening of facial features
Prognathism
Macroglossia
Arthritis
Increased incidence of obstructive sleep apnea
Increased incidence of glucose intolerance or frank diabetes mellitus, hypertension, and cardiovascular disease
Hyperphosphatemia, hypercalcuria, and hypertriglyceridemia possible
Increased incidence of congestive heart failure, which may be due to uncontrolled hypertension or to an intrinsic form of cardiomyopathy attributable to excess GH/IGF-I
Increased incidence of colonic polyps
Learn more about the presentation of acromegaly.
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Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Romesh Khardori. Fast Five Quiz: Test Your Knowledge of Acromegaly - Medscape - Sep 16, 2020.
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