Acromegaly is a chronic, debilitating, slowly progressive multisystem disorder caused by excessive secretion of growth hormone (GH). In the majority of cases, acromegaly results from benign pituitary adenomas; a benign tumor formed from glandular structures in epithelial tissue. In rare cases, acromegaly is caused by ectopic production of growth-hormone-releasing hormones (Patel, Ezzat and Chik).
The effects of acromegaly can be quite obvious. Andre the Giant may be one of the most famous examples of acromegaly that not many equate to the disease. “At 7'4" and 500 pounds, Andre the Giant could have been famous for his size alone. His drive, talent and ambition, however, proved to be as big as Andre himself, and the wrestler became legendary for his achievements in and out of the ring… Andre, however, suffered from acromegaly…also known as gigantism, this disease caused Andre's body to continue growing his whole life…Sadly, over the years the effects of acromegaly continued to wear down his body. Eventually his immense size was just too much for his heart, and Andre the Giant died in Paris, France in his hotel room on January 27, 1993” (Reserved). The following images demonstrate the effects of acromegaly on the body:
Skull x-ray showing acromegaly X-ray of an average skull
Hand x-ray showing acromegaly X-ray of an average hand
Comparing Andre the Giant to the average man
Disease Process and Etiology
Again, acromegaly results in excessive growth hormone in the body. “There is normal secretion of GH in childhood but hyper-secretion of GH in adulthood” (Roiger). This causes physical disfigurement as well as arthropathy, diabetes, hypertension, cardiac dysfunction, obstructive sleep apnea and colon cancer (Patel, Ezzat and Chik). “The epiphyseal plates have closed normally, preventing any further elongation of long bones, but all of the bones become more massive through appositional bone growth” (Roiger); growth in the bone diameter. This is very noticeable in bones of the face as the patient matures through adulthood. “Acromegaly is most often diagnosed in middle-aged adults, although symptoms can appear at any age” (Services).
Normal secretion of growth hormone is regulated by the hypothalamus. Normally, growth hormone from the hypothalamus is transported to the anterior pituitary gland where it is released. GH released from the anterior pituitary binds to and activates specific cells (Roiger). Growth hormone is released in a pulsatile manner and acts on the liver, bone, cartilage, muscle, and adipose tissue to stimulate the production of insulin-like growth factor-I (IGF-I). Circulating IGF-I in the body is derived mainly from the liver and feeds back on the anterior pituitary and hypothalamus to inhibit further growth hormone secretion (Patel, Ezzat and Chik).
In the case of acromegaly, growth hormone is...