Wednesday, May 2, 2012

Acromegaly

pituitary tumour secreting GH

GH stimulates prodxn of insulin-like GF (Sommatomedin C) in the liver

Organomegaly

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)


Tmt:
Carbagoline, Bromocriptine,
Octreotide

most respond to surgery.

Radiotherapy if not responsive

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