Swelling and thickening of the skin, growth and enlargement of the bones, especially if the hands, feet and face are caused by excess growth hormone.
Acromegaly or gigantism is a rare hormonal disorder than can develop when your pituitary gland overproduces the growth hormone. Most of the time this overproduction of the growth hormone is caused by a tumor. The excess growth hormone causes swelling, thickening of the skin, tissue growth and enlargement of the bones, especially in the hands, feet and face.
The overproduction of the growth hormone in children can lead to a condition known as gigantism. This may lead to an abnormal increase in the height and bone growth. Overproduction of the growth hormone in middle aged adults causes acromegaly.
The treatment of choice in pituitary tumors is surgery.
–
When surgery cannot be performed or if the entire tumor cannot be removed, then the treatment of choice is medications.
Somatostatin analogues (SSA) are synthetic versions of the hormone in the brain somatostatin. Two SSA’s are octreotide (Sandostatin, Sandostatin LAR) and lanreotide (Somatuline Depot). Somatostatin is a hormone that inhibits the release of the growth hormone. SSA’s can decrease the growth hormone levels by blocking the excess production in the pituitary gland. Common side effects are pain at the injection site, intestinal cramping, diarrhea and gallbladder problems.
Growth hormone receptor antagonists (GHRAs). The medication pegvisomant (Somavert) blocks the effect of growth hormone on the body tissues. It is administered daily by a subcutaneous injection. This medication can normalize growth hormone levels and relieve symptoms in most people affected by acromegaly. Some common side effects are headache, nausea, diarrhea and fatigue.
Dopamine agonists such as Cabergoline (Dostinex) and bromocroptine (Parlodel) are given to reduce production of the growth hormone and to shrink tumors. Both of these medications can be taken orally in pill form. They are not as effective as the SSA’s and GHRA’s. Sometimes doctors will prescribe a combination of Dopamine agonists with somatostatin analogues for treatment. Side effects that are common include headache, nausea and intestinal cramping. Pegvisomant has been used to treat acromegaly, or gigantism. It is a form of a growth hormone antagonist known as B2036. This growth hormone has increased disposition in one binding site and a lowered disposition in the second binding site. It has been shown that this molecule still enables reaction of the growth hormone receptor at the cell surface, but does not allow the necessary conformational changes.
A growth hormone deficiency may result in a condition known as dwarfism. Dwarfism can be defined as a short height, that is the result of a genetic or medical condition. Adults with dwarfism are usually less than four feet ten inches tall.
Treatments for conditions relating to dwarfism do not increase height, but may lessen complications.
Surgery is one treatment option for dwarfism. Some of the common procedures that are done surgically are to insert metal staples into the ends of long bones into the growth plate in order to correct the direction that the bones are growing. They can divide a limb bone, straighten it and insert a metal plate to hold it in place. They may insert rods or staples to correct the shape of the spine. They may increase the size of the opening in the vertebrae to alleviate pressure on the spinal cord.
Lengthening of the limbs is a treatment choice of people with dwarfism. During this procedure, the surgeon divides a long bone into two or more sections, slightly separates the sections and braces the bone and the limb with external metal “scaffolding”. Pins and screws on this frame are periodically adjusted to keep the tension between the sections, enabling the bone to grow back together gradually into a complete and longer bone.
Dwarfism is treated with injections of a synthetic version of the growth hormone. Children receive injections daily for several years until they reach a maximum adult height. Often this is the average adult range for their family.
People with dwarfism may encounter discrimination. Family support, social networks, advocacy groups and adaptive products enable most people with dwarfism to address challenges in educational, work and social settings.
Growth hormone deficiency is treated with injections of a synthetic version of the hormone. In most cases, children receive daily injections for several years until they reach a maximum adult height — often within the average adult range for their family. Treatment may continue throughout adolescence and early adulthood to ensure adult maturation, such as appropriate gain in muscle or fat. The treatment may be supplemented with other related hormones if they are also deficient. Treatment for girls with Turner syndrome also requires estrogen and related hormone therapy in order for them to begin puberty and achieve adult sexual development. Estrogen replacement therapy usually continues throughout life until a woman reaches the average age of menopaus
