Pathology:                    Increased growth hormonefollowing puberty after epiphyseal plate closure


Aetiology:                     Benign pituitary adenoma(95%), Excess growth hormone releasing hormone, tumours releasing growthhormone.


Symptoms:                   General change in appearance,excess sweating, headaches, visual changes, change in shoe/ring size, jointpains, sleep apnoea, symptoms of diabetes


Signs:                              Prognathism,frontal bossing, enlarged nose, deep voice, macroglossia, coarse skin texture, enlargementof hands and feet, nerve entrapment, multiple skin tags, goitre


Investigations:          Bloods:Fasting growth hormone and IGF-1 levels, glucose, U&E, lipid profile,

  pituitary profile

                                          OralGlucose Tolerance Test: No suppression of growth hormone in response

to glucose load

                                        Imaging: MRI pituitary

                                          ECG: To assess for cardiac abnormalities

                                        Special Tests: Skin thickness,photographs from the past, cancer screen


Treatment:                  Medical: Somatostatin analogues – inhibit growth hormone release,growth

hormone receptor antagonists ordopamine agonists

Surgical: Trans-sphenoidalsurgery


Complications:          Hypertension, heart failure, carpaltunnel syndrome, sleep apnoea, diabetes osteoarthritis, colonic polyps andcancer


Prognosis:                    90% cured by surgery. If leftuntreated mortality rate is double the rate for the








Rectangle: Rounded Corners: NOTE FOR PUBLISHERS – 

Image of the signs for Acromegaly










Figure 5.7 Signs of Acromegaly

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