Acromegaly

Acromegaly

• Vital signs: BP
  
  
• Weight,
  Height
  
  
• Typical face:
  
  
  • Frontal bossing
    
    
  • Prognathism
    
    
  • Macroglossia
    
    
  • Coarse
    faces
    
    
  • Thickening
    of the nose
    
    
• Cutis vertices gyrate
  
  
• Thyroid gland: enlarged,
  MNG
  
  
• Skin:
  skin
  tags, Oily skin, acanthosis
  nigrican
  
  
• Wide and spread
  hands.
  
  
• Carpal tunnel syndrome
  
  
• Heart: Cardiomegaly
  
  
• Abd: Hepatomegaly
  
  
• Nervous system:
  
  
  • VF
    
    
• Osteoarthritis
  
  
• Galactorrhea
  
  

 

IGF-1

• Screening test
  
  
• Higher than same age
  
  

• 75 g OGTT
  
  
  • GH
    > 1 ug/L
    
    
• Goal
  
  
  • GH
    < 1ug/L
    
    
  • Normalized IGF-1
    
• Modalities
  
  
  • Surgery
    
    
  • Radiation
    
    
  • Medication
    
    
    • Dopamine
      agonist
      
      
    • Somatostatin
      analog