Acromegaly and Gigantism: It’s all about excessive Growth Hormone…

Gigantism is excessive production of Growth Hormone (GH) in children which is extremely rare and leads to exaggerated bone growth and an abnormal increase in height. It results from high linear growth due to excessive action of insulin-like growth factor I (IGF-I) while the epiphyseal growth plates are open during childhood. Acromegaly is the same disorder of IGF-I excess but occurs after the growth plate cartilage fuses in adulthood. In Acromegaly, GH hypersecretion occurs after epiphyseal plate closure and stature is not affected. During adolescence, vertical growth is aggravated by hypogonadotropic hypogonadism and the resulting lack of gonadal steroids, which delays epiphyseal closure.

The Prevalence of Acromegaly is higher in the United States compared to the other countries. It is estimated that the Acromegaly prevalent cases in the 7 MM (United States, Germany, Italy, France, Spain, United Kingdom and Japan) may reach up to 55,607 cases by 2023. The low prevalence rate was found among men as compared to women in the United States. Female gender presented as a major risk factor. Higher prevalence of Acromegaly was observed in age-group 18–44 years (i.e., in adults) followed by the 45-64 years age group.

Pituitary gigantism is very rare and the description of the disease is limited to small series and case reports. People with gigantism have a 2x-3x higher mortality rate than people without the disorder. The prevalent cases of Gigantism in the United States are higher than the other European countries. It is estimated that the Gigantism prevalent cases in the 6 MM expected to reach up to 253 cases by the year 2023.

The main goal of treatment in Acromegaly and gigantism patients is to lower GH and IGF-1 levels to normal. Treatment may be Transnasal transsphenoidal surgery, Endoscopic transnasal transsphenoidal surgery, Pituitary irradiation or medications like Somatostatin analogues, Dopamine agonists and Growth hormone antagonist. A combination of all three or any two methods may be used for the treatment of Acromegaly.

Insight By:
Tejaswini Reddy
Associate Analyst

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