Acromegaly causes: Difference between revisions

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{{Acromegaly}}
{{Acromegaly}}
{{CMG}}
{{CMG}}; {{AE}} {{AEL}}  
==Overview==
==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.
Common causes of acromegaly include [[pituitary adenoma]] and [[acidophil]] [[stem cell]] adenomas. Less common causes of acromegaly include [[GHRH]] secreting tumors as [[hypothalamic]] [[tumors]], [[small cell lung cancer]], [[adrenal adenoma]], and [[pheochromocytoma]]. Other causes include [[GH]] secreting tumors as [[lymphoma]] and [[Pancreatic islet cell tumors|pancreatic islet cell tumor]].


==Causes==
==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.
==Overview==
*Disease name] may be caused by [cause1], [cause2], or [cause3].
*Common causes of [disease] include [cause1], [cause2], and [cause3].
*The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].
*The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here.
==Causes==
*Disease name] may be caused by [cause1], [cause2], or [cause3].
*Common causes of [disease] include [cause1], [cause2], and [cause3].
*The most common cause of [disease name] is [cause 1]. Less common causes of [disease name] include [cause 2], [cause 3], and [cause 4].
*The cause of [disease name] has not been identified. To review risk factors for the development of [disease name], click here
===Common Causes===
===Common Causes===
Acromegaly may be caused by:
Acromegaly may be caused by:
*Pituitary adenoma:<ref name="pmid6354702">{{cite journal| author=Melmed S, Braunstein GD, Horvath E, Ezrin C, Kovacs K| title=Pathophysiology of acromegaly. | journal=Endocr Rev | year= 1983 | volume= 4 | issue= 3 | pages= 271-90 | pmid=6354702 | doi=10.1210/edrv-4-3-271 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6354702  }}</ref>
*[[Pituitary adenoma]]:<ref name="pmid6354702" />
**The pituitary adenoma is a benign tumor in the pituitary gland and it resembles the most common cause of acromegaly.
**It is the most common cause of acromegaly.
**The pituitary adenoma is responsible for excessive secretion of the growth hormone and the insulin like growth factor-1.  
**A secretory [[pituitary adenoma]] is responsible for acromegaly by excess secretion of the growth hormone and the [[IGF-1|insulin like growth factor-1]] (IGF-1).  
*Other types of pituitary adenoma causing acromegaly:  
*Other types of [[Pituitary adenoma|pituitary adenomas]] causing acromegaly:  
**Mixed growth hormone and prolactin cell adenomas
**Mixed [[growth hormone]] and [[Prolactinoma|prolactin cell adenomas]]
**Acidophil stem cell adenomas
**[[Acidophil]] [[stem cell]] [[adenomas]]
**Mammosomatotroph cell adenomas
**Mammosomatotroph cell adenomas
**Pleurihormonal adenomas
**Pleurihormonal adenomas
===Less Common Causes===
===Less Common Causes===
Less common causes of acromegaly include:
Less common causes of acromegaly include:<ref name="pmid6354702">{{cite journal| author=Melmed S, Braunstein GD, Horvath E, Ezrin C, Kovacs K| title=Pathophysiology of acromegaly. | journal=Endocr Rev | year= 1983 | volume= 4 | issue= 3 | pages= 271-90 | pmid=6354702 | doi=10.1210/edrv-4-3-271 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6354702  }}</ref>
*Hypothalamic tumors which secrete Growth Hormone Releasing Hormone (GHRH).  
*[[Hypothalamus|Hypothalamic]] tumors which secrete growth hormone releasing hormone (GHRH).  
*Ectopic tumor secretion of GHRH.  
*[[Ectopic tumor]] secretion of [[GHRH]]. These tumors include the following:
*Ectopic tumor secretion of GH.  
**[[Small cell lung cancer]]
**[[Adrenal adenoma]]
**[[Pheochromocytoma]]
**[[Thyroid carcinoma]] 
*Ectopic tumor secretion of [[GH]]. These tumors include the following:
**[[Lymphoma]] 
**[[Pancreatic islet cell tumors]]


===Genetic Causes===
===Genetic Causes===
*[Disease name] is caused by a mutation in the [gene name] gene.
*Acromegaly is caused by a [[mutation]] in the guanine nucleotide stimulatory [[protein]] [[gene]] which is responsible for [[pituitary adenomas]].<ref name="pmid2549426">{{cite journal| author=Landis CA, Masters SB, Spada A, Pace AM, Bourne HR, Vallar L| title=GTPase inhibiting mutations activate the alpha chain of Gs and stimulate adenylyl cyclase in human pituitary tumours. | journal=Nature | year= 1989 | volume= 340 | issue= 6236 | pages= 692-6 | pmid=2549426 | doi=10.1038/340692a0 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2549426  }} </ref>
 
===Causes by Organ System===
 
{| style="width:80%; height:100px" border="1"
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
| style="width:75%" bgcolor="Beige" ; border="1" | No underlying causes
|-
| bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| bgcolor="Beige" | No underlying causes
|-
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| bgcolor="Beige" | No underlying causes
|-
|}
 
===Causes in Alphabetical Order===
List the causes of the disease in alphabetical order.
{{columns-list|3|
* Cause 1
* Cause 2
* Cause 3
* Cause 4
* Cause 5
* Cause 6
* Cause 7
* Cause 8
* Cause 9
* Cause 10
}}


==References==
==References==

Latest revision as of 19:05, 24 August 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Elsaiey, MBBCH [2]

Overview

Common causes of acromegaly include pituitary adenoma and acidophil stem cell adenomas. Less common causes of acromegaly include GHRH secreting tumors as hypothalamic tumors, small cell lung cancer, adrenal adenoma, and pheochromocytoma. Other causes include GH secreting tumors as lymphoma and pancreatic islet cell tumor.

Causes

Common Causes

Acromegaly may be caused by:

Less Common Causes

Less common causes of acromegaly include:[1]

Genetic Causes

References

  1. ↑ 1.0 1.1 Melmed S, Braunstein GD, Horvath E, Ezrin C, Kovacs K (1983). "Pathophysiology of acromegaly". Endocr Rev. 4 (3): 271–90. doi:10.1210/edrv-4-3-271. PMID 6354702.
  2. ↑ Landis CA, Masters SB, Spada A, Pace AM, Bourne HR, Vallar L (1989). "GTPase inhibiting mutations activate the alpha chain of Gs and stimulate adenylyl cyclase in human pituitary tumours". Nature. 340 (6236): 692–6. doi:10.1038/340692a0. PMID 2549426.


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