Acromegaly is a rare disease, but the diagnosis can be made on the street. It changes the patient’s appearance in a characteristic way.
People who see this person on a daily basis don’t often see it. The thickening of the facial features of Mr. Tomasz was noticed in the photos by his mother, who lives abroad. That’s why he was lucky: he was started on treatment early.
A famous person suffering from acromegaly was an American actor who lived in the first half of the twentieth century – Rondo Hatton. With his big nose and prominent lower jaw, he only played the roles of villains.
The disease is a chronic hormonal disorder caused by a tumor in the pituitary gland. They contribute to the excessive secretion of growth hormone (GH). There are two types of benign tumors that cause acromegaly: microadenoma (up to 10 millimeters in diameter) and macroadenoma (greater than 10 millimeters). At the time of diagnosis, 70 percent. adenomas already have a diameter of more than 20 millimeters.
Acromegaly affects 3-4 people per million per year. In Poland, about 2 people suffer from it. There are about 140 new cases every year. Untreated acromegaly shortens the patient’s life by 10 years, mostly due to complications from the cardiovascular system, caused by enlargement of the heart, and also due to cancer – most often of the colon.
In addition to external signs, such as enlargement of the hands, feet, nose, jaw, hirsutism and increased sweating, there are, among others, headache, bone and joint pain, difficulty breathing (and associated snoring), visual field defects, high blood pressure, decreased libido and menstrual disorders.
All of these symptoms can accompany other more common and more common diseases. This fact delays diagnosis, leading to further deformation and discomfort. The diagnosis is often made 5-10 years after the first symptoms appear.
The first – simple and cheap – test that should be performed when acromegaly is suspected is the assessment of the concentration of the growth factor IGF-1 in the blood (its level is elevated in patients).
A test for inhibition of growth hormone secretion after administration of glucose is also performed. Treatment is carried out by an endocrinologist, consulting doctors of other specialties.
The basic method of treatment is removal of the tumor through the nose and sphenoid sinus performed in a specialized neurosurgical center. In addition, drugs are administered (reimbursed somatostatin analogues), or irradiated. Complications such as heart disease, diabetes and cancer also need to be treated.
Early treatment is effective in inhibiting the progression of the disease. The trick is to recognize her in time.
Tekst: Ryszard Sterczyński