pituitary tumour secreting GH
GH stimulates prodxn of insulin-like GF (Sommatomedin C) in the liver
Increase in shoe size, increase in cap size, "can no longer remove wedding ring", coarse facial features, large tongue, body odour, deeper voice, joint pains, snoring, erectile dysfunction (co-secretion of prolactin by tumour)
Remember medscape Alan with Acromegaly . google this.
carpal tunnel syndrome, Obstructive sleep apnoe, DM/glucose intolerance, Hypertension, Congestive Heart Failure
Most common cause of death is CHF
Initial test: IGF level
Most accurate test: glucose suppression test (GH level post glucose ingestion is abnormally high)
most respond to surgery.
Radiotherapy if not responsive