What are the main clinical features of Acromegaly?

• coarse facial appearance, spade-like hands, increase in shoe size
• large tongue, prognathism, interdental spaces
• excessive sweating and oily skin: caused by sweat gland hypertrophy

How is Acromegaly diagnosed?

Serum IGF-1 levels if this is raised oral glucose tolerance test (OGTT) with serial GH measurements to confirm diagnosis

What are the main causes of Acromegaly?

excess growth hormone secondary to a pituitary adenoma in over 95% of cases

What are the common complications of Acromegaly?

• hypertension
• diabetes (>10%)
• cardiomyopathy
• colorectal cancer

Why is Growth hormone not useful in diagnosing Acromegaly?

vary during the day

What are the findings of Oral glucose tolerance test in Acromegaly?

no suppression of GH

What are the normal findings of Oral glucose tolerance test?

GH is suppressed to < 2 mu/L with hyperglycaemia

What are the features of pituitary tumour?

• hypopituitarism
• headaches
• bitemporal hemianopia

What is the treatment of Acromegaly?

Trans-sphenoidal surgery is the first-line treatment

What medication can be used in Acromegaly if the tumour is inoperable or non tumour cause?

• somatostatin analogue
• pegvisomant
• dopamine agonists

If surgical and medical management have failed for Acromegaly what is the final option?

External irradiation