DEFINITION
Growth hormone or growth hormone (GH) is responsible for
controlling the growth of bone and soft tissue. Increased growth hormone causes
overgrowth of bone and soft tissue. In adults, this condition can cause a rare
disorder called acromegaly. If not promptly treated, acromegaly can lead to
serious complications and death.
Excessive activity by the pituitary gland usually caused by
a tumor in the pituitary gland that normally can lead to increased growth
hormones, specifically. Abnormalities induced in accordance with the timing of
this tumor. If this occurs before the tumor growth stops, symptoms that occur
are giant body (gigantism). However, if these tumors occurred after growth
stops, certain parts of the body (such as the nose, chin, fingers and toes) are
experiencing abnormal growth (acromegaly).
CAUSE
The pituitary gland is a small gland located at the base of
the brain. These glands produce many hormones, including growth hormone (growth
hormone). In many cases, an increase in growth hormone due to a benign tumor on
the pituitary gland. And the small number of cases, malignant tumors in other
organs such as the pancreas, adrenal and lung cancer, the cause of the
increased growth hormone
SYMPTOMS
This hormonal disruption caused increase bone size, among
others, hand bones, legs, and face. Picture becomes rough facial bones, hands
and feet swell.
The symptoms can be found, among others:
-Abnormal growth and defects in:
·
Hands (rings no longer fit)
·
Foot (need shoes larger)
·
Face (brow and lower jaw protrude)
·
The jaw (teeth do not line up correctly when
closing the mouth)
·
Excessive jaw bone growth, so that stood out
·
Lip
·
Tongue.
-Carpal tunnel syndrome (increased pressure on wrist
nerves).
-Changes in the skin, such as:
·
Thickened skin, oily, and sometimes dark
·
Severe acne
·
Excessive sweating and unpleasant body scent due
to enlargement of the sweat glands.
-Voice sounded deeper due to enlarged sinuses, vocal cords,
and soft tissues of the throat.
-Weak in the legs and arms.
-Sleep apnea (breathing disorder during sleep).
-Arthritis and other problems in the joints, especially in
the jaw.
-Hypothyroidism (thyroid hormone deficiency).
-Liver, kidney, spleen, heart and / or other internal organs
abnormally large.
-In women:
·
Irregular menstrual cycles
·
Galactorrhea (abnormal breast milk production)
occurs in about 50 percent of cases.
In men:
·
Impotence occurs in about 50 percent of cases.
Acromegaly can cause various complications, such as:
·
High blood pressure (hypertension)
·
Heart and vascular disease, especially heart
enlargement
·
Diabetes mellitus
·
The growth of pre-cancers (polyps) in the colon
·
Sleep apnea, a condition in which breath will
repeatedly stops and starts during sleep back
·
A decrease in the production of other hormones
from the pituitary gland
·
Loss of eyesight
·
Emphasis on the spinal nerves
DIAGNOSIS
The doctor will ask about symptoms and medical history.
Physical examination will also be conducted. Acromegaly is often not diagnosed
until symptoms appear.
Blood tests will be done to measure the level of:
·
Insulin-like growth factor (IGF-I)
·
Growth hormone releasing hormone (GHRH)
·
and other pituitary hormones.
·
Glucose tolerance test may also be done to see
if the decline of growth hormone (not decreased in the case of acromegaly).
If these examinations reinforces the notion acromegaly, the
following checks can be done to locate the tumor or the cause of the increased
growth hormone:
·
CT Scan head
·
MRI Scan.
·
Radiological examination
TREATMENT
The goal of treatment in acromegaly is to:
·
Reduce the production of growth hormone to
normal levels.
·
Stop and reverse the symptoms caused by excess
growth hormone.
·
Correcting hormonal other endocrine
abnormalities (thyroid, adrenal, sex organs).
·
Reduce tumor size.
Treatment may include:
Operation
Tumors are believed to cause acromegaly may be removed. In
many cases, surgery is the best treatment option. Treatment with the drug more
popular as the primary treatment approach.
Radiotherapy
External radiation can be applied to shrink the tumor. This
is usually done when the operation is no longer possible or when treatment with
the drug did not show a positive response.
Drugs
Drugs that can be attributed to lower levels of growth
hormone, among others:
·
Cabergoline (Dostinex) - given orally.
·
Pergolide (Permax) - given orally.
·
Bromocriptine (Parlodel) - may be given
preoperatively to shrink the tumor.
·
Octreotide (Sandostatin) - via injection
(considered to be the most effective for this condition)
·
Pegvisomant - given by injection if other forms
of treatment does not give a positive response.
PREVENTION
Have not been found effective measures to prevent
acromegaly. Treatment as early as possible to save the patient from serious
complications.
REFERENCE
National Institute of Diabetes & Digestive & Kidney
Diseases. http://www.niddk.nih.gov/
The neuroendocrine Clinical Center and Pituitary Tumor
Center. http://pituitary.mgh.harvard.edu/pituitarytumors.htm
Pituitary Network Association. http://www.pituitary.org/
Canadian Society of Endocrinology and Metabolism.
http://www.endo-metab.ca/
Health Canada. http://www.hc-sc.gc.ca/index-eng.php
MayoClinic. Acromegaly. 2013.
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