Pathology - Acromegaly
Excess growth hormone (GH) secretion is the cause of amegaly. Excess GH secretion from a pituitary adenoma is nearly always the cause. Prolactin secretion and TSH secretion disruption are frequently present together, yet the patient in question does not have these complicating issues. The pituitary mass's pressure on the optic chiasm causes headache and temporal hemianopia. GH primarily stimulates the liver and other tissues to secrete more IGF-1, which in turn promotes somatic growth. Giantantism occurs in young patients prior to the closure of the epiphyseal growth plates. Acromegaly is characterized by the unique expansion of the skull, hands, feet, and facial characteristics in mature humans. Internal organ growth also takes place, with cardiomegaly being of special concern. Although its cause is unknown, hypertension is a common occurrence in individuals with anemia. People with excess GH often have insulin resistance and may develop diabetes mellitus (DM), as this patient did. This is because GH is generally an anti-insulin hormone that helps to maintain blood glucose levels in response to stresses. Transsphenoidal microsurgery, which removes the pituitary adenoma, is the preferred treatment and is effective in about 70% of cases.
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