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2024-06-24

Understanding Acromegaly: An Uncommon Disorder with Common Complications

Acromegaly is a slowly progressive disorder that often takes a decade to diagnose due to its gradual onset and common symptoms. This condition arises when the pituitary gland produces excessive growth hormone, leading to the liver’s overproduction of insulin-like growth factor (IGF-1). This hormonal imbalance triggers abnormal tissue and bone growth, affecting various bodily functions. The disorder can develop at any age after puberty but is most often diagnosed during the fourth and fifth decades of life.

Early signs often include:

  • Enlarged hands or feet
  • Changes in face shape, including a more prominent jaw and/or forehead
  • Increase in size of lips, nose and/or tongue
  • Excessive sweating or oily skin
  • Deepening of the voice
  • Headaches

If left untreated, acromegaly can cause a range of serious health complications. 

Common Complications of Acromegaly

Due to the systemic nature of acromegaly, it can lead to a myriad of complications, significantly impacting the patient’s quality of life. Here are some of the most common complications associated with acromegaly:

Bone Fracture and Osteoporosis

Acromegaly contributes to osteoporosis and bone fractures primarily through its effect on bone remodelling. Elevated growth hormone (GH) and IGF-1 levels can disrupt the balance between bone formation and resorption, often leading to increased bone turnover. Despite increased bone density, the quality of the bone may be compromised, resulting in reduced bone strength and a higher risk of fractures.

Sleep Apnea

Sleep apnea is prevalent among acromegaly patients. Excess soft tissue growth, particularly in the throat and tongue, can obstruct airways, causing repeated interruptions in breathing during sleep. This condition not only affects sleep quality but also poses significant cardiovascular risks.

Hypertension and Heart Failure

Hypertension is among the most common complications of acromegaly, due to the increased vascular resistance and blood volume associated with excess growth hormone. Over time, this elevated blood pressure can strain the heart, leading to hypertrophy and eventually heart failure if left unmanaged.

Carpal Tunnel Syndrome

The overgrowth of connective tissues and bones can compress the median nerve in the wrist, leading to carpal tunnel syndrome. Patients often experience numbness, tingling, and weakness in the hands, which can significantly impair daily activities and overall quality of life.

Diabetes

Excessive growth hormone interferes with insulin function, leading to insulin resistance and hyperglycemia. This metabolic disturbance puts acromegaly patients at a higher risk of developing type 2 diabetes, necessitating careful monitoring and management of blood glucose levels.

Colon Polyps

Acromegaly increases the risk of developing colon polyps, which are abnormal growths in the lining of the colon. Excess GH and IGF-1 promote cellular proliferation and inhibit apoptosis, which can lead to the formation of adenomatous polyps in the colon. ​These polyps can potentially become cancerous, highlighting the need for regular colonoscopic screenings in patients diagnosed with acromegaly.

Premature Death

The cumulative impact of these complications can shorten the life expectancy of individuals with acromegaly if not properly managed. Cardiovascular diseases, respiratory issues, and malignancies are the leading causes of premature death in these patients.

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Acromegaly is a complex disorder with far-reaching effects. Early diagnosis and comprehensive management are crucial to mitigate these complications and improve patient outcomes and quality of life. Medical professionals and primary care physicians play a vital role in recognizing the signs of acromegaly and coordinating appropriate treatment strategies.

Healthcare Professionals: Enhance your awareness of acromegaly with this 30-minute accredited course, Looking for the Zebra: Acromegaly — An Uncommon Cause Behind Common Conditions. 

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