wikidoc - User contributions [en]

Acromegaly overview

2016-10-06T22:46:28Z

Kathleen Jia: /* Epidemiology and Demographics */

__NOTOC__
{{Acromegaly}}
{{CMG}}
==Overview==
'''Acromegaly''' (from Greek ''akros'' "extreme" or "extremities" and ''megalos'' "large" - extremities enlargement) is a hormonal disorder that results from too much growth hormone in the body. The [[pituitary gland]], a small gland in the brain, makes growth hormone. In acromegaly, the pituitary produces excessive amounts of growth hormone, usually from a benign, or noncancerous, tumor on the pituitary gland. These benign tumors are called [[pituitary adenomas]].

Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious onset and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years. Common symptoms include slow enlargement of jaw, hands, feet, and coarsening of facial features. The most serious health consequences of acromegaly are [[type 2 diabetes]], [[high blood pressure]], increased risk of cardiovascular disease, and arthritis. Patients with acromegaly are also at increased risk for colon polyps, which may develop into [[colon cancer]] if not removed.

When growth hormone-producing adenomas occur in childhood, the disease that results is called gigantism rather than acromegaly. A child’s height is determined by the length of the so-called long bones in the legs. In response to growth hormone, these bones grow in length at the growth plates—areas near either end of the bone. Prior to puberty, excessive growth hormone exposure causes increased height. Growth plates fuse after puberty, so the excessive growth hormone production in adults does not affect height.

==Historical Perspective==
*The Dutch physician Johannes Wier who for the first time gave a clear medical description of a disease which became later known as acromegaly/gigantism
*Pierre Marie coined the term 'acromegaly' in 1886 and linked it to a distinct clinical disease with a characteristic clinical picture<ref name="pmid25572320">{{cite journal| author=de Herder WW| title=The History of Acromegaly. | journal=Neuroendocrinology | year= 2016 | volume= 103 | issue= 1 | pages= 7-17 | pmid=25572320 | doi=10.1159/000371808 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25572320 }} </ref>
*After Marie, pituitary enlargement was noted in almost all patients with acromegaly. Subsequently it was discovered that pituitary hyperfunction caused by a pituitary tumor was indeed the cause of acromegaly.

==Classification==
There is no classification system established for acromegaly

==Pathophysiology==
Acromegaly is caused by prolonged overproduction of growth hormone by the pituitary gland. Growth hormone is part of a cascade of hormones that, as the name implies, regulates the physical growth of the body. This cascade begins in a part of the brain called the [[hypothalamus]], which makes hormones that regulate the pituitary. One of the hormones in the GH axis is growth hormone-releasing hormone (GHRH), which stimulates the pituitary gland to produce GH.

Secretion of GH by the pituitary into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce GH production.

The hypothalamus makes another hormone called [[somatostatin]], which inhibits GH production and release. Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make GH independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease.

==Causes==
Acromegaly is caused by prolonged overproduction of growth hormone, most commonly by the pituitary gland by benign tumors called pituitary adenomas. It can also be caused by non-pituitary tumors that make growth hormone or growth hormone releasing hormone, but this is very rare.

==Differentiating {{PAGENAME}} from Other Diseases==

==Epidemiology and Demographics==
Acromegaly is rare with an estimated prevalence of 36–60 cases per million with an annual incidence of 3–4 per million. Acromegaly is often recognized and diagnosed in middle-aged men or women but can occur at any age. The disease is equally distributed between both sexes<ref name="pmid11081170">{{cite journal| author=Holdaway IM, Rajasoorya C| title=Epidemiology of acromegaly. | journal=Pituitary | year= 1999 | volume= 2 | issue= 1 | pages= 29-41 | pmid=11081170 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11081170 }} </ref>.

==Risk Factors==

==Screening==
Screening for acromegaly in the general population is not recommended.

==Natural History, Complications, and Prognosis==
===Natural History===

===Complications===

===Prognosis===

==Diagnosis==
===Diagnostic Criteria===

===History and Symptoms===

===Physical Examination===

===Laboratory Findings===

===Imaging Findings===

===Other Diagnostic Studies===

==Treatment==
===Medical Therapy===

===Surgery===

===Prevention===

==References==
{{reflist|2}}

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Endocrinology]]

Acromegaly overview

2016-10-06T22:30:42Z

Kathleen Jia: /* Screening */

__NOTOC__
{{Acromegaly}}
{{CMG}}
==Overview==
'''Acromegaly''' (from Greek ''akros'' "extreme" or "extremities" and ''megalos'' "large" - extremities enlargement) is a hormonal disorder that results from too much growth hormone in the body. The [[pituitary gland]], a small gland in the brain, makes growth hormone. In acromegaly, the pituitary produces excessive amounts of growth hormone, usually from a benign, or noncancerous, tumor on the pituitary gland. These benign tumors are called [[pituitary adenomas]].

Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious onset and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years. Common symptoms include slow enlargement of jaw, hands, feet, and coarsening of facial features. The most serious health consequences of acromegaly are [[type 2 diabetes]], [[high blood pressure]], increased risk of cardiovascular disease, and arthritis. Patients with acromegaly are also at increased risk for colon polyps, which may develop into [[colon cancer]] if not removed.

When growth hormone-producing adenomas occur in childhood, the disease that results is called gigantism rather than acromegaly. A child’s height is determined by the length of the so-called long bones in the legs. In response to growth hormone, these bones grow in length at the growth plates—areas near either end of the bone. Prior to puberty, excessive growth hormone exposure causes increased height. Growth plates fuse after puberty, so the excessive growth hormone production in adults does not affect height.

==Historical Perspective==
*The Dutch physician Johannes Wier who for the first time gave a clear medical description of a disease which became later known as acromegaly/gigantism
*Pierre Marie coined the term 'acromegaly' in 1886 and linked it to a distinct clinical disease with a characteristic clinical picture<ref name="pmid25572320">{{cite journal| author=de Herder WW| title=The History of Acromegaly. | journal=Neuroendocrinology | year= 2016 | volume= 103 | issue= 1 | pages= 7-17 | pmid=25572320 | doi=10.1159/000371808 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25572320 }} </ref>
*After Marie, pituitary enlargement was noted in almost all patients with acromegaly. Subsequently it was discovered that pituitary hyperfunction caused by a pituitary tumor was indeed the cause of acromegaly.

==Classification==
There is no classification system established for acromegaly

==Pathophysiology==
Acromegaly is caused by prolonged overproduction of growth hormone by the pituitary gland. Growth hormone is part of a cascade of hormones that, as the name implies, regulates the physical growth of the body. This cascade begins in a part of the brain called the [[hypothalamus]], which makes hormones that regulate the pituitary. One of the hormones in the GH axis is growth hormone-releasing hormone (GHRH), which stimulates the pituitary gland to produce GH.

Secretion of GH by the pituitary into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce GH production.

The hypothalamus makes another hormone called [[somatostatin]], which inhibits GH production and release. Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make GH independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease.

==Causes==
Acromegaly is caused by prolonged overproduction of growth hormone, most commonly by the pituitary gland by benign tumors called pituitary adenomas. It can also be caused by non-pituitary tumors that make growth hormone or growth hormone releasing hormone, but this is very rare.

==Differentiating {{PAGENAME}} from Other Diseases==

==Epidemiology and Demographics==

==Risk Factors==

==Screening==
Screening for acromegaly in the general population is not recommended.

==Natural History, Complications, and Prognosis==
===Natural History===

===Complications===

===Prognosis===

==Diagnosis==
===Diagnostic Criteria===

===History and Symptoms===

===Physical Examination===

===Laboratory Findings===

===Imaging Findings===

===Other Diagnostic Studies===

==Treatment==
===Medical Therapy===

===Surgery===

===Prevention===

==References==
{{reflist|2}}

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Endocrinology]]

Acromegaly classification

2016-10-06T22:13:16Z

Kathleen Jia: /* Overview */

__NOTOC__
{{Acromegaly}}
{{CMG}} {{AE}}

{{PleaseHelp}}

==Overview==
There is no classification system established for acromegaly

==Classification==

==References==
{{reflist|2}}

[[Category:Endocrinology]]

{{WS}}
{{WH}}

Acromegaly pathophysiology

2016-10-06T22:12:43Z

Kathleen Jia: /* Overview */

__NOTOC__
{{Acromegaly}}
{{CMG}} {{AE}}

{{PleaseHelp}}

==Overview==
Acromegaly is caused by prolonged overproduction of GH by the pituitary gland. GH is part of a cascade of hormones that, as the name implies, regulates the physical growth of the body. This cascade begins in a part of the brain called the hypothalamus. The hypothalamus makes hormones that regulate the pituitary. One of the hormones in the GH series, or "axis," is growth hormone-releasing hormone (GHRH), which stimulates the pituitary gland to produce GH.

Secretion of GH by the pituitary into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce GH production.

The hypothalamus makes another hormone called [[somatostatin]], which inhibits GH production and release. Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make GH independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease.

==Pathophysiology==
Growth hormone is synthesized and stored in somatotroph cells, which account for >50% of pituitary hormone secreting cells. Growth hormone production and secretion is regulated by hypothalamic GH-releasing hormone, ghrelin and somatostatin. IGF-1 inhibits growth hormone secretion by both direct effect on the somatrophs and indirectly through stimulation of somatostatin that inhibits growth hormone secretion. Growth hormone is secreted in sporadic pulses with minimal basal secretion determined by sex, age, neurotransmitters, exercise and stress.

Growth hormone action is achieved via its interaction with a single-chain transmembrane glycoprotein receptor (GHR). The growth hormone molecule interacts with a preformed dimer of identical GHR pairs, causing internalization of the receptor to initiate signaling. As a consequence, two Janus tyrosine kinase 2 molecules undergo autophosphorylation and in turn phosphorylate the GHR cytoplasmic domain. This activates intracellular proteins involved in signal transduction and transcription (STAT).

The gene encoding the GHR is ubiquitously expressed, particularly in liver, fat and muscle. Growth hormone activation of the intracellular molecule STAT5b induces transcription of IGF-1. Systemic IGF-1 is synthesized primarily in the liver but also in extraheptatic tissues including bone, muscle and kidney and in the pituitary gland itself. IGF-1 circulates in serum bound to IGF-1 binding protein (IGFBP-3), or IGFBP-5, and acid-labile subunit in a 150-kD complex. Less than 1% of total serum IGF-1 circulates as a free hormone. The IGF-1 cellular effects are mediated by the IGF-1 receptor (IGF-1R), a heterotetrameric protein structurally similar to the insulin receptor. IGF-1 acts to mediate tissue growth or locally synthesized IGF-1 acts in a paracrine manner to regulate local GH target tissue growth<ref name="pmid26873451">{{cite journal| author=Dineen R, Stewart PM, Sherlock M| title=Acromegaly. | journal=QJM | year= 2016 | volume= | issue= | pages= | pmid=26873451 | doi=10.1093/qjmed/hcw004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26873451 }} </ref>.

==References==
{{reflist|2}}

[[Category:Endocrinology]]

{{WS}}
{{WH}}

Acromegaly overview

2016-10-06T22:10:27Z

Kathleen Jia: /* Pathophysiology */

__NOTOC__
{{Acromegaly}}
{{CMG}}
==Overview==
'''Acromegaly''' (from Greek ''akros'' "extreme" or "extremities" and ''megalos'' "large" - extremities enlargement) is a hormonal disorder that results from too much growth hormone in the body. The [[pituitary gland]], a small gland in the brain, makes growth hormone. In acromegaly, the pituitary produces excessive amounts of growth hormone, usually from a benign, or noncancerous, tumor on the pituitary gland. These benign tumors are called [[pituitary adenomas]].

Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious onset and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years. Common symptoms include slow enlargement of jaw, hands, feet, and coarsening of facial features. The most serious health consequences of acromegaly are [[type 2 diabetes]], [[high blood pressure]], increased risk of cardiovascular disease, and arthritis. Patients with acromegaly are also at increased risk for colon polyps, which may develop into [[colon cancer]] if not removed.

When growth hormone-producing adenomas occur in childhood, the disease that results is called gigantism rather than acromegaly. A child’s height is determined by the length of the so-called long bones in the legs. In response to growth hormone, these bones grow in length at the growth plates—areas near either end of the bone. Prior to puberty, excessive growth hormone exposure causes increased height. Growth plates fuse after puberty, so the excessive growth hormone production in adults does not affect height.

==Historical Perspective==
*The Dutch physician Johannes Wier who for the first time gave a clear medical description of a disease which became later known as acromegaly/gigantism
*Pierre Marie coined the term 'acromegaly' in 1886 and linked it to a distinct clinical disease with a characteristic clinical picture<ref name="pmid25572320">{{cite journal| author=de Herder WW| title=The History of Acromegaly. | journal=Neuroendocrinology | year= 2016 | volume= 103 | issue= 1 | pages= 7-17 | pmid=25572320 | doi=10.1159/000371808 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25572320 }} </ref>
*After Marie, pituitary enlargement was noted in almost all patients with acromegaly. Subsequently it was discovered that pituitary hyperfunction caused by a pituitary tumor was indeed the cause of acromegaly.

==Classification==
There is no classification system established for acromegaly

==Pathophysiology==
Acromegaly is caused by prolonged overproduction of growth hormone by the pituitary gland. Growth hormone is part of a cascade of hormones that, as the name implies, regulates the physical growth of the body. This cascade begins in a part of the brain called the [[hypothalamus]], which makes hormones that regulate the pituitary. One of the hormones in the GH axis is growth hormone-releasing hormone (GHRH), which stimulates the pituitary gland to produce GH.

Secretion of GH by the pituitary into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce GH production.

The hypothalamus makes another hormone called [[somatostatin]], which inhibits GH production and release. Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make GH independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease.

==Causes==
Acromegaly is caused by prolonged overproduction of growth hormone, most commonly by the pituitary gland by benign tumors called pituitary adenomas. It can also be caused by non-pituitary tumors that make growth hormone or growth hormone releasing hormone, but this is very rare.

==Differentiating {{PAGENAME}} from Other Diseases==

==Epidemiology and Demographics==

==Risk Factors==

==Screening==

==Natural History, Complications, and Prognosis==
===Natural History===

===Complications===

===Prognosis===

==Diagnosis==
===Diagnostic Criteria===

===History and Symptoms===

===Physical Examination===

===Laboratory Findings===

===Imaging Findings===

===Other Diagnostic Studies===

==Treatment==
===Medical Therapy===

===Surgery===

===Prevention===

==References==
{{reflist|2}}

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Endocrinology]]

Acromegaly overview

2016-10-06T22:09:34Z

Kathleen Jia: /* Pathophysiology */

__NOTOC__
{{Acromegaly}}
{{CMG}}
==Overview==
'''Acromegaly''' (from Greek ''akros'' "extreme" or "extremities" and ''megalos'' "large" - extremities enlargement) is a hormonal disorder that results from too much growth hormone in the body. The [[pituitary gland]], a small gland in the brain, makes growth hormone. In acromegaly, the pituitary produces excessive amounts of growth hormone, usually from a benign, or noncancerous, tumor on the pituitary gland. These benign tumors are called [[pituitary adenomas]].

Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious onset and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years. Common symptoms include slow enlargement of jaw, hands, feet, and coarsening of facial features. The most serious health consequences of acromegaly are [[type 2 diabetes]], [[high blood pressure]], increased risk of cardiovascular disease, and arthritis. Patients with acromegaly are also at increased risk for colon polyps, which may develop into [[colon cancer]] if not removed.

When growth hormone-producing adenomas occur in childhood, the disease that results is called gigantism rather than acromegaly. A child’s height is determined by the length of the so-called long bones in the legs. In response to growth hormone, these bones grow in length at the growth plates—areas near either end of the bone. Prior to puberty, excessive growth hormone exposure causes increased height. Growth plates fuse after puberty, so the excessive growth hormone production in adults does not affect height.

==Historical Perspective==
*The Dutch physician Johannes Wier who for the first time gave a clear medical description of a disease which became later known as acromegaly/gigantism
*Pierre Marie coined the term 'acromegaly' in 1886 and linked it to a distinct clinical disease with a characteristic clinical picture<ref name="pmid25572320">{{cite journal| author=de Herder WW| title=The History of Acromegaly. | journal=Neuroendocrinology | year= 2016 | volume= 103 | issue= 1 | pages= 7-17 | pmid=25572320 | doi=10.1159/000371808 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25572320 }} </ref>
*After Marie, pituitary enlargement was noted in almost all patients with acromegaly. Subsequently it was discovered that pituitary hyperfunction caused by a pituitary tumor was indeed the cause of acromegaly.

==Classification==
There is no classification system established for acromegaly

==Pathophysiology==
Acromegaly is caused by prolonged overproduction of growth hormone by the pituitary gland. Growth hormone is part of a cascade of hormones that, as the name implies, regulates the physical growth of the body. This cascade begins in a part of the brain called the [hypothalamus], which makes hormones that regulate the pituitary. One of the hormones in the GH axis is growth hormone-releasing hormone (GHRH), which stimulates the pituitary gland to produce GH.

Secretion of GH by the pituitary into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce GH production.

The hypothalamus makes another hormone called [somatostatin], which inhibits GH production and release. Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make GH independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease.

==Causes==
Acromegaly is caused by prolonged overproduction of growth hormone, most commonly by the pituitary gland by benign tumors called pituitary adenomas. It can also be caused by non-pituitary tumors that make growth hormone or growth hormone releasing hormone, but this is very rare.

==Differentiating {{PAGENAME}} from Other Diseases==

==Epidemiology and Demographics==

==Risk Factors==

==Screening==

==Natural History, Complications, and Prognosis==
===Natural History===

===Complications===

===Prognosis===

==Diagnosis==
===Diagnostic Criteria===

===History and Symptoms===

===Physical Examination===

===Laboratory Findings===

===Imaging Findings===

===Other Diagnostic Studies===

==Treatment==
===Medical Therapy===

===Surgery===

===Prevention===

==References==
{{reflist|2}}

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Endocrinology]]

Acromegaly overview

2016-10-06T22:08:39Z

Kathleen Jia: /* Causes */

__NOTOC__
{{Acromegaly}}
{{CMG}}
==Overview==
'''Acromegaly''' (from Greek ''akros'' "extreme" or "extremities" and ''megalos'' "large" - extremities enlargement) is a hormonal disorder that results from too much growth hormone in the body. The [[pituitary gland]], a small gland in the brain, makes growth hormone. In acromegaly, the pituitary produces excessive amounts of growth hormone, usually from a benign, or noncancerous, tumor on the pituitary gland. These benign tumors are called [[pituitary adenomas]].

Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious onset and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years. Common symptoms include slow enlargement of jaw, hands, feet, and coarsening of facial features. The most serious health consequences of acromegaly are [[type 2 diabetes]], [[high blood pressure]], increased risk of cardiovascular disease, and arthritis. Patients with acromegaly are also at increased risk for colon polyps, which may develop into [[colon cancer]] if not removed.

When growth hormone-producing adenomas occur in childhood, the disease that results is called gigantism rather than acromegaly. A child’s height is determined by the length of the so-called long bones in the legs. In response to growth hormone, these bones grow in length at the growth plates—areas near either end of the bone. Prior to puberty, excessive growth hormone exposure causes increased height. Growth plates fuse after puberty, so the excessive growth hormone production in adults does not affect height.

==Historical Perspective==
*The Dutch physician Johannes Wier who for the first time gave a clear medical description of a disease which became later known as acromegaly/gigantism
*Pierre Marie coined the term 'acromegaly' in 1886 and linked it to a distinct clinical disease with a characteristic clinical picture<ref name="pmid25572320">{{cite journal| author=de Herder WW| title=The History of Acromegaly. | journal=Neuroendocrinology | year= 2016 | volume= 103 | issue= 1 | pages= 7-17 | pmid=25572320 | doi=10.1159/000371808 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25572320 }} </ref>
*After Marie, pituitary enlargement was noted in almost all patients with acromegaly. Subsequently it was discovered that pituitary hyperfunction caused by a pituitary tumor was indeed the cause of acromegaly.

==Classification==
There is no classification system established for acromegaly

==Pathophysiology==
Acromegaly is caused by prolonged overproduction of growth hormone by the pituitary gland. Growth hormone is part of a cascade of hormones that, as the name implies, regulates the physical growth of the body. This cascade begins in a part of the brain called the hypothalamus, which makes hormones that regulate the pituitary. One of the hormones in the GH axis is growth hormone-releasing hormone (GHRH), which stimulates the pituitary gland to produce GH.

Secretion of GH by the pituitary into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce GH production.

The hypothalamus makes another hormone called somatostatin, which inhibits GH production and release. Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make GH independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease.

==Causes==
Acromegaly is caused by prolonged overproduction of growth hormone, most commonly by the pituitary gland by benign tumors called pituitary adenomas. It can also be caused by non-pituitary tumors that make growth hormone or growth hormone releasing hormone, but this is very rare.

==Differentiating {{PAGENAME}} from Other Diseases==

==Epidemiology and Demographics==

==Risk Factors==

==Screening==

==Natural History, Complications, and Prognosis==
===Natural History===

===Complications===

===Prognosis===

==Diagnosis==
===Diagnostic Criteria===

===History and Symptoms===

===Physical Examination===

===Laboratory Findings===

===Imaging Findings===

===Other Diagnostic Studies===

==Treatment==
===Medical Therapy===

===Surgery===

===Prevention===

==References==
{{reflist|2}}

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Endocrinology]]

Acromegaly causes

2016-10-06T22:07:07Z

Kathleen Jia: /* Overview */

__NOTOC__
{{Acromegaly}}
{{CMG}}
==Overview==
Acromegaly is caused by prolonged overproduction of growth hormone, most commonly by the pituitary gland by benign tumors called pituitary adenomas. It can also be produced in non-pituitary tumors but this is very rare.

==Causes==
===Pituitary adenoma===
In over 90 percent of acromegaly patients, the overproduction of GH is caused by a benign tumor of the pituitary gland, called an [[pituitary adenoma|adenoma]]. These tumors produce excess GH and, as they expand, compress surrounding brain tissues, such as the optic nerves. This expansion causes the headaches and visual disturbances that are often symptoms of acromegaly. In addition, compression of the surrounding normal pituitary tissue can alter production of other [[hormones]], leading to changes in menstruation and breast discharge in women and [[impotence]] in men because of reduced [[testosterone]] production.

There is a marked variation in rates of GH production and the aggressiveness of the tumor. Some adenomas grow slowly and symptoms of GH excess are often not noticed for many years. Other adenomas grow rapidly and invade surrounding brain areas or the sinuses, which are located near the pituitary. In general, younger patients tend to have more aggressive tumors.

Most pituitary tumors arise spontaneously and are not genetically inherited. Many pituitary tumors arise from a genetic alteration in a single pituitary cell which leads to increased cell division and tumor formation. This genetic change, or [[mutation]], is not present at birth, but is acquired during life. The mutation occurs in a gene that regulates the transmission of chemical signals within pituitary cells; it permanently switches on the signal that tells the cell to divide and secrete GH. The events within the cell that cause disordered pituitary [[cell growth]] and GH oversecretion currently are the subject of intensive research.

===Other tumors===
In a few patients, acromegaly is caused not by pituitary tumors but by [[tumor]]s of the [[pancreas]], [[lung]]s, and [[adrenal gland]]s. These tumors also lead to an excess of GH, either because they produce GH themselves or, more frequently, because they produce GHRH, the hormone that stimulates the pituitary to make GH. In these patients, the excess GHRH can be measured in the blood and establishes that the cause of the acromegaly is not due to a pituitary defect. When these non-pituitary tumors are surgically removed, GH levels fall and the symptoms of acromegaly improve.

==References==
{{reflist|2}}

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Endocrinology]]

Acromegaly overview

2016-10-06T22:05:49Z

Kathleen Jia: /* Pathophysiology */

__NOTOC__
{{Acromegaly}}
{{CMG}}
==Overview==
'''Acromegaly''' (from Greek ''akros'' "extreme" or "extremities" and ''megalos'' "large" - extremities enlargement) is a hormonal disorder that results from too much growth hormone in the body. The [[pituitary gland]], a small gland in the brain, makes growth hormone. In acromegaly, the pituitary produces excessive amounts of growth hormone, usually from a benign, or noncancerous, tumor on the pituitary gland. These benign tumors are called [[pituitary adenomas]].

Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious onset and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years. Common symptoms include slow enlargement of jaw, hands, feet, and coarsening of facial features. The most serious health consequences of acromegaly are [[type 2 diabetes]], [[high blood pressure]], increased risk of cardiovascular disease, and arthritis. Patients with acromegaly are also at increased risk for colon polyps, which may develop into [[colon cancer]] if not removed.

When growth hormone-producing adenomas occur in childhood, the disease that results is called gigantism rather than acromegaly. A child’s height is determined by the length of the so-called long bones in the legs. In response to growth hormone, these bones grow in length at the growth plates—areas near either end of the bone. Prior to puberty, excessive growth hormone exposure causes increased height. Growth plates fuse after puberty, so the excessive growth hormone production in adults does not affect height.

==Historical Perspective==
*The Dutch physician Johannes Wier who for the first time gave a clear medical description of a disease which became later known as acromegaly/gigantism
*Pierre Marie coined the term 'acromegaly' in 1886 and linked it to a distinct clinical disease with a characteristic clinical picture<ref name="pmid25572320">{{cite journal| author=de Herder WW| title=The History of Acromegaly. | journal=Neuroendocrinology | year= 2016 | volume= 103 | issue= 1 | pages= 7-17 | pmid=25572320 | doi=10.1159/000371808 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25572320 }} </ref>
*After Marie, pituitary enlargement was noted in almost all patients with acromegaly. Subsequently it was discovered that pituitary hyperfunction caused by a pituitary tumor was indeed the cause of acromegaly.

==Classification==
There is no classification system established for acromegaly

==Pathophysiology==
Acromegaly is caused by prolonged overproduction of growth hormone by the pituitary gland. Growth hormone is part of a cascade of hormones that, as the name implies, regulates the physical growth of the body. This cascade begins in a part of the brain called the hypothalamus, which makes hormones that regulate the pituitary. One of the hormones in the GH axis is growth hormone-releasing hormone (GHRH), which stimulates the pituitary gland to produce GH.

Secretion of GH by the pituitary into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce GH production.

The hypothalamus makes another hormone called somatostatin, which inhibits GH production and release. Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make GH independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease.

==Causes==

==Differentiating {{PAGENAME}} from Other Diseases==

==Epidemiology and Demographics==

==Risk Factors==

==Screening==

==Natural History, Complications, and Prognosis==
===Natural History===

===Complications===

===Prognosis===

==Diagnosis==
===Diagnostic Criteria===

===History and Symptoms===

===Physical Examination===

===Laboratory Findings===

===Imaging Findings===

===Other Diagnostic Studies===

==Treatment==
===Medical Therapy===

===Surgery===

===Prevention===

==References==
{{reflist|2}}

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Endocrinology]]

Acromegaly causes

2016-10-06T22:03:30Z

Kathleen Jia: /* Overview */

__NOTOC__
{{Acromegaly}}
{{CMG}}
==Overview==
Acromegaly is caused by prolonged overproduction of growth hormone by the pituitary gland. Growth hormone is part of a cascade of hormones that, as the name implies, regulates the physical growth of the body. This cascade begins in a part of the brain called the hypothalamus, which makes hormones that regulate the pituitary. One of the hormones in the GH axis is growth hormone-releasing hormone (GHRH), which stimulates the pituitary gland to produce GH.

Secretion of GH by the pituitary into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce GH production.

The hypothalamus makes another hormone called somatostatin, which inhibits GH production and release. Normally, GHRH, somatostatin, GH, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make GH independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease.

==Causes==
===Pituitary adenoma===
In over 90 percent of acromegaly patients, the overproduction of GH is caused by a benign tumor of the pituitary gland, called an [[pituitary adenoma|adenoma]]. These tumors produce excess GH and, as they expand, compress surrounding brain tissues, such as the optic nerves. This expansion causes the headaches and visual disturbances that are often symptoms of acromegaly. In addition, compression of the surrounding normal pituitary tissue can alter production of other [[hormones]], leading to changes in menstruation and breast discharge in women and [[impotence]] in men because of reduced [[testosterone]] production.

There is a marked variation in rates of GH production and the aggressiveness of the tumor. Some adenomas grow slowly and symptoms of GH excess are often not noticed for many years. Other adenomas grow rapidly and invade surrounding brain areas or the sinuses, which are located near the pituitary. In general, younger patients tend to have more aggressive tumors.

Most pituitary tumors arise spontaneously and are not genetically inherited. Many pituitary tumors arise from a genetic alteration in a single pituitary cell which leads to increased cell division and tumor formation. This genetic change, or [[mutation]], is not present at birth, but is acquired during life. The mutation occurs in a gene that regulates the transmission of chemical signals within pituitary cells; it permanently switches on the signal that tells the cell to divide and secrete GH. The events within the cell that cause disordered pituitary [[cell growth]] and GH oversecretion currently are the subject of intensive research.

===Other tumors===
In a few patients, acromegaly is caused not by pituitary tumors but by [[tumor]]s of the [[pancreas]], [[lung]]s, and [[adrenal gland]]s. These tumors also lead to an excess of GH, either because they produce GH themselves or, more frequently, because they produce GHRH, the hormone that stimulates the pituitary to make GH. In these patients, the excess GHRH can be measured in the blood and establishes that the cause of the acromegaly is not due to a pituitary defect. When these non-pituitary tumors are surgically removed, GH levels fall and the symptoms of acromegaly improve.

==References==
{{reflist|2}}

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Endocrinology]]

Acromegaly overview

2016-10-06T22:00:29Z

Kathleen Jia: /* Pathophysiology */

Acromegaly overview

2016-10-06T22:00:10Z

Kathleen Jia: /* Causes */

Acromegaly pathophysiology

2016-10-06T21:59:05Z

Kathleen Jia: /* Overview */

__NOTOC__
{{Acromegaly}}
{{CMG}} {{AE}}

{{PleaseHelp}}

==Overview==
Acromegaly is a hormonal disorder that results from too much growth hormone in the body. Growth hormone is made by the pituitary gland in the brain, usually by a benign pituitary adenoma.

Secretion of growth hormone by the pituitary gland into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce growth hormone production.

==Pathophysiology==
Growth hormone is synthesized and stored in somatotroph cells, which account for >50% of pituitary hormone secreting cells. Growth hormone production and secretion is regulated by hypothalamic GH-releasing hormone, ghrelin and somatostatin. IGF-1 inhibits growth hormone secretion by both direct effect on the somatrophs and indirectly through stimulation of somatostatin that inhibits growth hormone secretion. Growth hormone is secreted in sporadic pulses with minimal basal secretion determined by sex, age, neurotransmitters, exercise and stress.

Growth hormone action is achieved via its interaction with a single-chain transmembrane glycoprotein receptor (GHR). The growth hormone molecule interacts with a preformed dimer of identical GHR pairs, causing internalization of the receptor to initiate signaling. As a consequence, two Janus tyrosine kinase 2 molecules undergo autophosphorylation and in turn phosphorylate the GHR cytoplasmic domain. This activates intracellular proteins involved in signal transduction and transcription (STAT).

The gene encoding the GHR is ubiquitously expressed, particularly in liver, fat and muscle. Growth hormone activation of the intracellular molecule STAT5b induces transcription of IGF-1. Systemic IGF-1 is synthesized primarily in the liver but also in extraheptatic tissues including bone, muscle and kidney and in the pituitary gland itself. IGF-1 circulates in serum bound to IGF-1 binding protein (IGFBP-3), or IGFBP-5, and acid-labile subunit in a 150-kD complex. Less than 1% of total serum IGF-1 circulates as a free hormone. The IGF-1 cellular effects are mediated by the IGF-1 receptor (IGF-1R), a heterotetrameric protein structurally similar to the insulin receptor. IGF-1 acts to mediate tissue growth or locally synthesized IGF-1 acts in a paracrine manner to regulate local GH target tissue growth<ref name="pmid26873451">{{cite journal| author=Dineen R, Stewart PM, Sherlock M| title=Acromegaly. | journal=QJM | year= 2016 | volume= | issue= | pages= | pmid=26873451 | doi=10.1093/qjmed/hcw004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26873451 }} </ref>.

==References==
{{reflist|2}}

[[Category:Endocrinology]]

{{WS}}
{{WH}}

Acromegaly causes

2016-10-06T21:57:26Z

Kathleen Jia: /* Overview */

__NOTOC__
{{Acromegaly}}
{{CMG}}
==Overview==
Acromegaly is a hormonal disorder that results from too much growth hormone in the body. Growth hormone is made by the pituitary gland in the brain, usually by a benign pituitary adenoma.

Secretion of growth hormone by the pituitary gland into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce growth hormone production.

==Causes==
===Pituitary adenoma===
In over 90 percent of acromegaly patients, the overproduction of GH is caused by a benign tumor of the pituitary gland, called an [[pituitary adenoma|adenoma]]. These tumors produce excess GH and, as they expand, compress surrounding brain tissues, such as the optic nerves. This expansion causes the headaches and visual disturbances that are often symptoms of acromegaly. In addition, compression of the surrounding normal pituitary tissue can alter production of other [[hormones]], leading to changes in menstruation and breast discharge in women and [[impotence]] in men because of reduced [[testosterone]] production.

There is a marked variation in rates of GH production and the aggressiveness of the tumor. Some adenomas grow slowly and symptoms of GH excess are often not noticed for many years. Other adenomas grow rapidly and invade surrounding brain areas or the sinuses, which are located near the pituitary. In general, younger patients tend to have more aggressive tumors.

Most pituitary tumors arise spontaneously and are not genetically inherited. Many pituitary tumors arise from a genetic alteration in a single pituitary cell which leads to increased cell division and tumor formation. This genetic change, or [[mutation]], is not present at birth, but is acquired during life. The mutation occurs in a gene that regulates the transmission of chemical signals within pituitary cells; it permanently switches on the signal that tells the cell to divide and secrete GH. The events within the cell that cause disordered pituitary [[cell growth]] and GH oversecretion currently are the subject of intensive research.

===Other tumors===
In a few patients, acromegaly is caused not by pituitary tumors but by [[tumor]]s of the [[pancreas]], [[lung]]s, and [[adrenal gland]]s. These tumors also lead to an excess of GH, either because they produce GH themselves or, more frequently, because they produce GHRH, the hormone that stimulates the pituitary to make GH. In these patients, the excess GHRH can be measured in the blood and establishes that the cause of the acromegaly is not due to a pituitary defect. When these non-pituitary tumors are surgically removed, GH levels fall and the symptoms of acromegaly improve.

==References==
{{reflist|2}}

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Endocrinology]]

Acromegaly pathophysiology

2016-10-06T21:56:50Z

Kathleen Jia: /* Pathophysiology */

__NOTOC__
{{Acromegaly}}
{{CMG}} {{AE}}

{{PleaseHelp}}

==Overview==

==Pathophysiology==
Growth hormone is synthesized and stored in somatotroph cells, which account for >50% of pituitary hormone secreting cells. Growth hormone production and secretion is regulated by hypothalamic GH-releasing hormone, ghrelin and somatostatin. IGF-1 inhibits growth hormone secretion by both direct effect on the somatrophs and indirectly through stimulation of somatostatin that inhibits growth hormone secretion. Growth hormone is secreted in sporadic pulses with minimal basal secretion determined by sex, age, neurotransmitters, exercise and stress.

Growth hormone action is achieved via its interaction with a single-chain transmembrane glycoprotein receptor (GHR). The growth hormone molecule interacts with a preformed dimer of identical GHR pairs, causing internalization of the receptor to initiate signaling. As a consequence, two Janus tyrosine kinase 2 molecules undergo autophosphorylation and in turn phosphorylate the GHR cytoplasmic domain. This activates intracellular proteins involved in signal transduction and transcription (STAT).

The gene encoding the GHR is ubiquitously expressed, particularly in liver, fat and muscle. Growth hormone activation of the intracellular molecule STAT5b induces transcription of IGF-1. Systemic IGF-1 is synthesized primarily in the liver but also in extraheptatic tissues including bone, muscle and kidney and in the pituitary gland itself. IGF-1 circulates in serum bound to IGF-1 binding protein (IGFBP-3), or IGFBP-5, and acid-labile subunit in a 150-kD complex. Less than 1% of total serum IGF-1 circulates as a free hormone. The IGF-1 cellular effects are mediated by the IGF-1 receptor (IGF-1R), a heterotetrameric protein structurally similar to the insulin receptor. IGF-1 acts to mediate tissue growth or locally synthesized IGF-1 acts in a paracrine manner to regulate local GH target tissue growth<ref name="pmid26873451">{{cite journal| author=Dineen R, Stewart PM, Sherlock M| title=Acromegaly. | journal=QJM | year= 2016 | volume= | issue= | pages= | pmid=26873451 | doi=10.1093/qjmed/hcw004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26873451 }} </ref>.

==References==
{{reflist|2}}

[[Category:Endocrinology]]

{{WS}}
{{WH}}

Acromegaly overview

2016-10-06T21:36:28Z

Kathleen Jia: /* Causes */

Acromegaly overview

2016-09-30T05:47:37Z

Kathleen Jia: /* Classification */

__NOTOC__
{{Acromegaly}}
{{CMG}}
==Overview==
'''Acromegaly''' (from Greek ''akros'' "extreme" or "extremities" and ''megalos'' "large" - extremities enlargement) is a hormonal disorder that results from too much growth hormone in the body. The [[pituitary gland]], a small gland in the brain, makes growth hormone. In acromegaly, the pituitary produces excessive amounts of growth hormone, usually from a benign, or noncancerous, tumor on the pituitary gland. These benign tumors are called [[pituitary adenomas]].

Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious onset and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years. Common symptoms include slow enlargement of jaw, hands, feet, and coarsening of facial features. The most serious health consequences of acromegaly are [[type 2 diabetes]], [[high blood pressure]], increased risk of cardiovascular disease, and arthritis. Patients with acromegaly are also at increased risk for colon polyps, which may develop into [[colon cancer]] if not removed.

When growth hormone-producing adenomas occur in childhood, the disease that results is called gigantism rather than acromegaly. A child’s height is determined by the length of the so-called long bones in the legs. In response to growth hormone, these bones grow in length at the growth plates—areas near either end of the bone. Prior to puberty, excessive growth hormone exposure causes increased height. Growth plates fuse after puberty, so the excessive growth hormone production in adults does not affect height.

==Historical Perspective==
*The Dutch physician Johannes Wier who for the first time gave a clear medical description of a disease which became later known as acromegaly/gigantism
*Pierre Marie coined the term 'acromegaly' in 1886 and linked it to a distinct clinical disease with a characteristic clinical picture<ref name="pmid25572320">{{cite journal| author=de Herder WW| title=The History of Acromegaly. | journal=Neuroendocrinology | year= 2016 | volume= 103 | issue= 1 | pages= 7-17 | pmid=25572320 | doi=10.1159/000371808 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25572320 }} </ref>
*After Marie, pituitary enlargement was noted in almost all patients with acromegaly. Subsequently it was discovered that pituitary hyperfunction caused by a pituitary tumor was indeed the cause of acromegaly.

==Classification==
There is no classification system established for acromegaly

==Pathophysiology==

==Causes==
Acromegaly is a hormonal disorder that results from too much growth hormone in the body. Growth hormone is made by the pituitary gland in the brain, usually by a benign pituitary adenoma.

Secretion of growth hormone by the pituitary gland into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce growth hormone production.

The hypothalamus makes another hormone called somatostatin, which inhibits growth hormone production and release. Normally, GHRH, somatostatin, growth hormone, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make growth hormone independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease.

==Differentiating {{PAGENAME}} from Other Diseases==

==Epidemiology and Demographics==

==Risk Factors==

==Screening==

==Natural History, Complications, and Prognosis==
===Natural History===

===Complications===

===Prognosis===

==Diagnosis==
===Diagnostic Criteria===

===History and Symptoms===

===Physical Examination===

===Laboratory Findings===

===Imaging Findings===

===Other Diagnostic Studies===

==Treatment==
===Medical Therapy===

===Surgery===

===Prevention===

==References==
{{reflist|2}}

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Endocrinology]]

Acromegaly overview

2016-09-30T05:44:32Z

Kathleen Jia: /* Historical Perspective */

__NOTOC__
{{Acromegaly}}
{{CMG}}
==Overview==
'''Acromegaly''' (from Greek ''akros'' "extreme" or "extremities" and ''megalos'' "large" - extremities enlargement) is a hormonal disorder that results from too much growth hormone in the body. The [[pituitary gland]], a small gland in the brain, makes growth hormone. In acromegaly, the pituitary produces excessive amounts of growth hormone, usually from a benign, or noncancerous, tumor on the pituitary gland. These benign tumors are called [[pituitary adenomas]].

Acromegaly most commonly affects middle-aged adults and can result in serious illness and premature death. Because of its insidious onset and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years. Common symptoms include slow enlargement of jaw, hands, feet, and coarsening of facial features. The most serious health consequences of acromegaly are [[type 2 diabetes]], [[high blood pressure]], increased risk of cardiovascular disease, and arthritis. Patients with acromegaly are also at increased risk for colon polyps, which may develop into [[colon cancer]] if not removed.

When growth hormone-producing adenomas occur in childhood, the disease that results is called gigantism rather than acromegaly. A child’s height is determined by the length of the so-called long bones in the legs. In response to growth hormone, these bones grow in length at the growth plates—areas near either end of the bone. Prior to puberty, excessive growth hormone exposure causes increased height. Growth plates fuse after puberty, so the excessive growth hormone production in adults does not affect height.

==Historical Perspective==
*The Dutch physician Johannes Wier who for the first time gave a clear medical description of a disease which became later known as acromegaly/gigantism
*Pierre Marie coined the term 'acromegaly' in 1886 and linked it to a distinct clinical disease with a characteristic clinical picture<ref name="pmid25572320">{{cite journal| author=de Herder WW| title=The History of Acromegaly. | journal=Neuroendocrinology | year= 2016 | volume= 103 | issue= 1 | pages= 7-17 | pmid=25572320 | doi=10.1159/000371808 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25572320 }} </ref>
*After Marie, pituitary enlargement was noted in almost all patients with acromegaly. Subsequently it was discovered that pituitary hyperfunction caused by a pituitary tumor was indeed the cause of acromegaly.

==Classification==

==Pathophysiology==

==Causes==
Acromegaly is a hormonal disorder that results from too much growth hormone in the body. Growth hormone is made by the pituitary gland in the brain, usually by a benign pituitary adenoma.

Secretion of growth hormone by the pituitary gland into the bloodstream stimulates the liver to produce another hormone called insulin-like growth factor I (IGF-I). IGF-I is what actually causes tissue growth in the body. High levels of IGF-I, in turn, signal the pituitary to reduce growth hormone production.

The hypothalamus makes another hormone called somatostatin, which inhibits growth hormone production and release. Normally, GHRH, somatostatin, growth hormone, and IGF-I levels in the body are tightly regulated by each other and by sleep, exercise, stress, food intake, and blood sugar levels. If the pituitary continues to make growth hormone independent of the normal regulatory mechanisms, the level of IGF-I continues to rise, leading to bone overgrowth and organ enlargement. High levels of IGF-I also cause changes in glucose (sugar) and lipid (fat) metabolism and can lead to diabetes, high blood pressure, and heart disease.

==Differentiating {{PAGENAME}} from Other Diseases==

==Epidemiology and Demographics==

==Risk Factors==

==Screening==

==Natural History, Complications, and Prognosis==
===Natural History===

===Complications===

===Prognosis===

==Diagnosis==
===Diagnostic Criteria===

===History and Symptoms===

===Physical Examination===

===Laboratory Findings===

===Imaging Findings===

===Other Diagnostic Studies===

==Treatment==
===Medical Therapy===

===Surgery===

===Prevention===

==References==
{{reflist|2}}

{{WikiDoc Help Menu}}
{{WikiDoc Sources}}

[[Category:Endocrinology]]

Acromegaly overview

2016-09-27T08:36:20Z

Kathleen Jia: /* Causes */

Acromegaly overview

2016-09-27T08:12:42Z

Kathleen Jia: /* Overview */

Acromegaly overview

2016-09-27T08:11:47Z

Kathleen Jia: /* Overview */

Acromegaly overview

2016-09-27T08:06:31Z

Kathleen Jia: /* Overview */