Acromegaly in South Africa

• Swelling of the hands and feet
• The brow and lower jaw protrude leading to teeth space out
• Overgrowth of bone and cartilage leading to carpal tunnel syndrome
• Numbness and weakness of the hands
• Enlargement of body organs such as the heart
• Joint aches
• Thick, coarse, oily skin
• Enlarged lips, nose, tongue, sinuses and vocal cords
• Deepening of the voice
• Sleep apnea
• Excessive sweating and skin odor
• Fatigue and weakness
• Headaches and impaired vision
• Menstrual cycle abnormalities and sometimes breast discharge in women
• Erectile dysfunction and decreased libido

Growth hormone levels: Your doctor will measure the growth hormone level in your blood to see if it is elevated. This test is accurate when done under conditions that suppress the secretion of growth hormones.IGF-I levels: Your doctor can also measure your Insulin-like Growth Factor levels which increase as Growth hormone increase.

MRI: After diagnosis using blood tests, an MRI (Magnetic resonance imaging of the pituitary is done to locate the tumor causing the overproduction of the growth hormone and also to detect the size.CT scan: Computerized tomography scan can diagnose possible tumor sites.

Treatment options include:

• Surgery: This is done if the tumor has not yet invaded surrounding nonpituitary tissues. After surgery, hormone levels have to be measured to determine whether a cure has been achieved, which can take up to several weeks because IGF-I lasts a long time in the body's circulation.
• Medication: This option is done if the surgery does not normalize the hormone levels or a relapse occurs. Long-term therapy is necessary because their withdrawal can lead to rising growth hormone levels and tumor re-expansion.
• Radiation therapy: This form of treatment is done on patients who are not good candidates for surgery or do not respond adequately to surgery and medication.    
• Side effects include:
  

• Infertility
• Vision loss and brain injury
• Digestive problems such as loose stools, nausea, and gas
• Gallstones
• Elevated blood glucose levels.
• A need for lifelong use of pituitary hormone replacement.
• Cerebrospinal fluid leaks
• Meningitis.
• Headaches, fatigue
• Abnormal liver function.

Acromegaly is a hormonal disorder due to too much growth hormone in the body because of a benign tumor of the pituitary gland. Common features of acromegaly include abnormal growth of the hands and feet; bone growth in the face that leads to a protruding lower jaw and brow as well as an enlarged nasal bone. It can cause sleep apnea, fatigue and weakness, aches and is diagnosed through a blood test or MRI. The common treatment is usually surgical removal of the tumor. Medication or radiation may also be used instead of or in addition to surgery.