Acromegaly Initial Assessment

Clinical Presentation

Signs and symptoms of excess GH and/or IGF-1 include soft tissue swelling and extremity enlargement, hyperhidrosis (excessive sweating), hypogonadism symptoms, coarsening of facial features, prognathism, macroglossia, arthritis, gigantism, metabolic effects (eg hyperphosphatemia, hypercalciuria, hypertriglyceridemia, and low high-density lipoprotein C), and increased incidence of the following: Obstructive sleep apnea, diabetes mellitus (DM) and glucose intolerance, cardiovascular diseases (eg hypertension, coronary heart disease [CHD]), thyroid disorders (eg multinodular goiter), and colonic polyps and adenocarcinoma.  

Symptoms caused by the suprasellar extension of the pituitary adenoma may also be noted such as visual field defects, diplopia (secondary to cranial nerve palsy), headache, and loss of pituitary function resulting in lethargy, menstrual dysfunction, erectile dysfunction, infertility, and loss of libido.

Acromegaly.ai_Initial Assesment

Diagnosis or Diagnostic Criteria

Early diagnosis of acromegaly is difficult as most signs and symptoms are due to long-standing overproduction of the GH and IGF-1 causing metabolic, endocrine, and morphological changes. Patients suspected of having acromegaly should undergo biochemical testing to confirm the diagnosis, followed by imaging to determine the cause.