Acromegalia

General characteristic of a disease

Acromegalia, it in use giantism – a serious neuroendocrinal disease. It is caused by hypersecretion of hormone of Somatotropinum, a so-called growth hormone.

Giantism it is accepted to call an acromegalia at patients of children's and teenage age. The increased development of Somatotropinum at them leads to excess linear growth. At patients of adult age growth of soft tissues and a periosteum, and also an excessive set of weight is characteristic of an acromegalia.

The acromegalia develops in 99% of cases as a result of hypophysis adenoma. At an acromegalia there is a pathological increase in all internals of the person: hearts, lungs, spleen, liver, intestines and pancreas. Their hypertrophy is fraught with a sklerozirovaniye of fabrics and development of multiorgan insufficiency. Besides, the patient with symptoms of an acromegalia has an increased probability of formation of kind and malignant tumors.

The acromegalia meets on average at 50 on 1 million people. The sex of the patient of a role does not play. Most often adenoma of a hypophysis and an acromegalia as its investigation, are diagnosed for people of 40-60 years.

Acromegalia reasons

The prevailing number of cases of the diagnosed acromegalia results from pure somatotropic adenoma (it is a somatotropinoma). The acromegalia can be also combined. Supersecretion of Somatotropinum and prolactin or Somatotropinum and other kinds of adenogipofizarny hormones is the reason of adenoma of this type.

So among the reasons of an acromegalia call pathologies of secretion of hormones:

• TTG (thyritropic hormone),
• LG (luteinizing hormone or lyuteotropin),
• FSG (follicle-stimulating hormone),
• and - subunits, etc.

As the acromegalia reason in most cases serve mutations of somatotrof. So the special type of a secretory granule of a hypophysis is called.

The acromegalia can also develop as a result of MEN-1 syndrome (a multiple endocrine neoplasia). Formation of numerous tumors in a hypophysis, thyroid and thymic glands, adrenal glands, a nervous system and digestive tract is characteristic of this disease of a hereditary etiology.

Acromegalia symptoms

Symptoms of an acromegalia have slow rate of increase. On average at adult age the disease is diagnosed only 10 years later after manifestation of the first symptoms of an acromegalia.

Refer appearance changes to the main symptoms of an acromegalia. Exactly thanks to them – coarsening of features, increase in malars, superciliary arches, a mandible – the person can have a suspicion about existence of a disease at it.

Soft tissues at the patient with symptoms of an acromegalia are hypertrophied: language, ears, a nose, lips, brushes and feet are slightly increased. During further progressing of a disease there is a change of a bite due to growth of interdental spaces.

At patients of children's and teenage age the main symptom of an acromegalia is the excessive rate of linear growth advancing all age norms.

Among additional symptoms of an acromegalia call:

• arthralgia (excess formation of cartilaginous tissue),
• the increased perspiration and excessive activity of sebaceous glands,
• consolidation of an upper layer of skin,
• splanchnomegaly (increase in a spleen)
• the degeneration of muscle fibers causing decrease in working capacity and small physical activity.

Chronic hyperproduction of Somatotropinum at an acromegalia can result in multiple multiorgan insufficiency. A symptom of an acromegalia of a late stage of development is the myocardium hypertrophy, heart failure and the increased intracranial pressure.

The apnoea syndrome – the threat of an apnoea in a dream caused by growth of tissues of airways is diagnosed for 90% of patients with symptoms of an acromegalia.

Acromegalia – also the reason of erectile dysfunction at men and disturbances of a menstrual cycle at women of childbearing age.

Diagnosis of an acromegalia

The acromegalia is diagnosed on the basis of data of a blood analysis on the IRF-1 level (somatomedin C). At normal indicators carrying out the provocative test with loading glucose is recommended. For this purpose at the patient with suspicion of an acromegalia blood sampling each 30 minutes 4 times a day is made.

For visualization of the reason of an acromegalia - adenoma of a hypophysis brain MRT is carried out. In diagnosis of a disease also the exception of possible complications of an acromegalia is important: diabetes mellitus, polypose of intestines, heart failure, craw, etc.

Treatment of an acromegalia

Main objective of treatment of an acromegalia – normalization of development of Somatotropinum. For this purpose to the patient surgical removal of adenoma of a hypophysis is carried out. The operational treatment of an acromegalia provoked by tumors of the small sizes in 85% of cases leads to normal secretion of hormones and to permanent remission. Surgical treatment of the acromegalia caused by a tumor of a hypophysis of the large sizes is effective only in a third of cases.

In conservative treatment of an acromegalia antagonists of Somatotropinum – artificial analogs of hormone of somatostatin are applied: Lanreotid and Oktreotid. Thanks to their regular use for 50% of patients it is possible to normalize the level of hormones, and also to cause reduction of the sizes of a tumor of a hypophysis.

It is possible to reduce synthesis of a growth hormone also reception of blockers of receptors of somatotrof, for example, by Pegvisomantom. This technique of treatment of an acromegalia still needs additional studying.

Beam treatment of an acromegalia is considered inefficient as an independent method of therapy and can be applied only as a part of complex measures of fight against a disease.