Acromegaly: causes, course, treatment

Acromegaly is a neuroendocrinal disease that manifests itself in pathological enlargement of individual parts of the body, which is associated with excessive secretion of growth hormone (growth hormone) by the anterior pituitary gland, due to its tumor lesion. This disease develops in adults and manifests itself as a noticeable enlargement of facial features (mandible, lips, nose, ears), an increase in hands and feet, permanent articular and headaches; a violation of the reproductive and sexual functions both in women and men. In addition, the presence in the blood of an elevated level of growth hormone leads to early deaths from cancer, cardiovascular and pulmonary diseases. Acromegaly is a very rare endocrine pathology (4 people per 100,000 population), which affects both men and women equally, and mainly develops between the ages of 40 and 60.

This pathology begins to develop only after the growth of the organism stops. For quite a long period, the symptoms begin to increase gradually and changes in appearance appear. In most cases, acromegaly is diagnosed after about seven years from the onset of the disease

What is growth hormone

Growth hormone / growth hormone is produced in the pituitary gland (small endocrine gland located in the bone excavation "Turkish saddle", located at the base of the brain) and provides the children with the processes of formation of muscles, bones and processes of linear growth; and in adults is responsible for controlling metabolism (water-salt metabolism, fat metabolism, carbohydrate metabolism).

Control for the correct functioning of the pituitary gland is provided by the hypothalamus, which produces substances that inhibit or stimulate the production of hormones by the pituitary gland.

The content of growth hormone in a healthy person during the day is subject to certain fluctuations (maximum values ​​are in the early morning hours). With the development of acromegaly, not only the elevated level of somatotropic hormone is observed, but a violation of the normal rhythm of its release into the blood

Causes of acromegaly

Pituitary cells responsible for the production of growth hormone, for certain reasons, cease to be susceptible to the regulating influence of the hypothalamus and begin to multiply more rapidly and, accordingly, to actively produce somatotropic hormone. Due to the continued growth of these cells, a benign pituitary tumor (pituitary adenoma) is formed, which in some cases can reach a few centimeters in size (the size of the pituitary gland up to 1 centimeter), while unchanged pituitary cells can be compressed or destroyed.

, грипп и пр.), заболевания центральной нервной системы, травмы черепа, неблагоприятное течение беременности In most cases, the emergence of this disease contributes to mental trauma, chronic and acute infections ( measles , influenza , etc.), central nervous system diseases, skull injuries, unfavorable course of pregnancy

Manifestations

In its current, acromegaly is divided into several stages:

- Pre-macromegalic: it is revealed quite rarely, since manifestations are not sufficiently pronounced

- Hypertrophic: characterized by an expanded clinical disease

- Tumor: Symptoms are dominated by signs of influence on nearby tissues and organs (nerve and eye disorders, increased intracranial pressure)

- Cachectic (stage of exhaustion): is the outcome of acromegaly

, головокружение, нарушение зрения, повышенную утомляемость, боли в пояснице и суставах. Patients complain of headaches , dizziness, visual impairment, increased fatigue, pain in the lower back and joints. Appearance of the patient becomes quite peculiar: there is an increase in the nose, cheekbones, superciliary arches, ears and lips; feet and hands acquire the so-called shovel-like appearance; the enlarged lower jaw protrudes forward; the voice is noticeably coarsening.

Changes in skin integument are observed: in areas of rubbing with clothing and in the area of ​​skin folds, there is increased moisture and fat content (due to an increase in the size and quantity of sebaceous and sweat glands).

At the initial stages of the disease, there is an increase in muscle strength, which, as the disease progresses, is replaced by muscle weakness. At the initial stages of acromegaly, the functions of the enlarged internal organs practically do not change, but later signs of hepatic, pulmonary and cardiac failure are added.

In some cases, the severity and field of vision is reduced, almost all women are disrupted by the menstrual cycle (it is possible to separate milk from the breasts, not associated with childbirth or pregnancy), a third of men have a decreased potency.

If the growth of the tumor is directed mainly toward the hypothalamus, patients are thirsty, drowsy, polyuria (increase in the number and volume of urination), decreases acuity of hearing, there are sharp increases in body temperature; may cause epilepsy

Treatment

Treatment of acromegaly includes a whole range of measures that are aimed at reducing the concentration of growth hormone in the blood serum:

- Decreased level of somatotropin with the help of medications

- Prevent further increase in size, or removal of pituitary tumor

If surgical treatment did not bring the desired results, remote gamma-therapy is applied. Diet is prescribed without fail.

In the absence of adequate treatment and with an adverse course of acromegaly, the life expectancy of patients is three to four years; and with a slow development and favorable flow - from ten to thirty years. The prognosis for life with timely adequate treatment is quite favorable, full recovery is not ruled out.

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