Partial gigantism. Excess function of the pituitary gland: gigantism. Existing treatments for gigantism

Gigantism is associated with dysfunction of the pituitary gland. Pathologically high growth, frequent fainting, difficulties with the intellect and disorders in the genital area are all consequences of gigantism. There are several varieties of the disease, but 2 main groups can be distinguished:

• Diseases that began in childhood.
• Pathologies that started in adulthood.

They are united by one thing - increased tissue division under the influence of an abnormally large amount of the hormone produced by the pituitary gland - somatotropin. Children have "growth zones" in the joints. This is the cartilage of the tubular bone, where there is an active cell division. Therefore, a child can grow up to 2 meters in adolescence.

Note. In adults, these zones are normally absent. At the end of puberty, they are closed by bone tissue, human growth stops.

There are various pathologies of the closure of "growth zones":

• The immunity of the receptors of these zones to sex hormones, under the influence of which the body of a teenager is formed. As a result, the child's limbs and all internal organs continue to grow, and sexual development is delayed.
• Although the “growth zones” were closed, the production of the hormone increased incredibly. The result will be the development of acromegaly or partial gigantism. Hormones stimulate tissue cell division where there is cartilage tissue.

Note. This does not apply to families where a high body growth rate is genetically determined. In these cases, development occurs in proportion, harmoniously and stops in due time. Such tall people can have offspring, which cannot be said about patients with gigantism.

Often, with a fairly high growth, such people have a small head, curved X-shaped legs, and there is also a lack of secondary sexual characteristics (hair growth does not occur, skeletal features are not formed according to the male or female type).

After a brain injury, acromegaly, a type of gigantism, can begin. At the same time, the face, ears, nose grow. The feet and hands can be incredibly enlarged. The tongue increases in volume and does not allow to chew food normally and pronounce words clearly. This condition is caused by a pituitary adenoma and is treated with surgery.

Existing varieties of gigantism

Endocrinology distinguishes the following types of this disease.

Causes of pathology

In 90% of cases, the cause of gigantism is a pituitary adenoma. The remaining 10% share the following reasons:

• Compression of the pituitary gland by a brain tumor, as a result of which an increase in the production of somatotropin begins.
• Metastases of tumors from the internal organs go to the brain.
• Infection leading to an inflammatory process in the pituitary gland. This is a common complication after influenza or encephalitis.

Recommendation. It is necessary to treat infectious diseases so that there are no consequences. Complications after the flu or encephalitis lead to an inflammatory process in the pituitary gland. This can give impetus to the onset of the disease.

Gigantism Symptoms

According to the consequences of exposure to the body, the following groups of symptoms can be distinguished:

1. Pathological proliferation of bone tissue:

• Limb lengthening.
• Hyperdevelopment of the hands and feet.
• The bones of the face increase, the appearance coarsens.
• The lower jaw expands, gaps appear between the teeth.
• The nose is enlarged and deformed.

Acromegaly is expressed by a massive, protruding chin. The superciliary ridges are enlarged and protrude forward. Prominent cheekbones. Unusually tall. All this together is a reason to undergo diagnostic tests for the state of the pituitary gland.

1. Hypertrophy of internal organs:

• Cardiomegaly.
• Enlargement of the liver.
• Enlargement of the intestine.
• Enlargement of the vocal cords (voice change).

1. Compression Syndrome:

• Constant headaches.
• Pain behind the eyes and in the superciliary arches.

Note. According to the handbook of neurology, every third person has some kind of disorder in the pituitary gland.

1. Endocrine diseases:

• Increased sweating.
• Acceleration of metabolism.
• Acceleration of the pulse.
• Irritability.

1. Violation of sexual functions:

• Cessation of menses.
• Decreased potency and sexual desire.

1. Mental disorders.

1. neurological disorders.

Methods for diagnosing gigantism

To confirm the diagnosis, there are various samples and tests that determine the level of somatomedins. Biochemical tests show the level of total protein and glucose in the blood. Tests for hormones are often prescribed, since all body systems do not work properly.

One of the most important methods is ophthalmoscopy. Radiological methods are also used.

Existing treatments for gigantism

Gigantism treatment is designed to reduce the amount of growth hormone. If there are already concomitant diseases, funds are added to correct them.

Drug therapy

• Somatostatin (Octreotide). Synthetic hormone that inhibits growth.
• Bromocriptine ("Parlodel"). Stimulates the production of dopamine, which inhibits the synthesis of growth hormone.

Radiation radiotherapy

• X-ray therapy. Suppression of tumor growth and a decrease in the production of somatotropin.
• Treatment by irradiation of a directed neutron beam.

Surgery

Preventive measures

Modern medicine attaches great importance to the timely detection of various pathologies. Therefore, constant monitoring of the development of the child will significantly reduce the percentage of gigantism in children. It is important to identify the onset of the disease in time and adhere to the following tips:

• Seek immediate medical attention.
• Timely treatment of influenza.
• Avoid head injury.
• Keep hormone levels under control.
• Dispensary observation at the endocrinologist and ophthalmologist.

Modern endocrinology has learned to detect early pathologies. Efficient methods of treatment have been developed. If you follow all the prescriptions of doctors, the quality of life will improve.

The development of gigantism is associated with increased production of somatotropic hormone and incomplete ossification of the children's skeleton.

Endocrinologists identify the following reasons for the development of pathology in a child:

• hyperplasia of pituitary cells, an increase in the cells themselves leads to a violation of their function - they begin to produce much more hormones;
• hyperfunction of the right lobe of the pituitary gland, this anomaly can occur due to traumatic brain injury, infection with meningitis or encephalitis, brain intoxication, development of pituitary gland adenoma;
• low sensitivity of epiphasic cartilage to sex hormones, which leads to the continued growth of all bones even in transitional and more mature age.

Symptoms

Gigantism can develop in various ways. Depending on the type of disease, the clinical picture will also change.

• Partial (another name is partial) gigantism is an increase in the size of one or more parts of the body, which leads to a disproportionate physique. This type of gigantism can turn into acromegaly, which requires immediate surgical intervention;
• Splanchnomegaly is an excessive increase and weighting of the internal organs. This condition can be determined by the results of ultrasound, in some cases there is a protrusion of an enlarged organ;
• Eunuchal gigantism is manifested by long limbs, the absence of secondary sexual characteristics and a violation of the functionality of the gonads;
• Half gigantism - only one half of the body begins to increase dramatically in size;
• Cerebral gigantism - an increase in the pituitary gland, in which there is an organic lesion of the brain with a violation of thought processes.

There are also general symptoms of the disease, which most often begins to appear during puberty - 12-14 years:

• dynamic increase in growth,
• general weakness and fatigue,
• joint pain,
• blurred vision and headaches,
• memory loss,
• weakness and low tone of the muscular corset,
• asthenia.

During the development of gigantism, hormonal changes also occur:

• early development of amenorrhea in girls,
• hypofunction of germ cells in men,
• diabetes and diabetes insipidus,
• hyper- and hypothyroidism.

Diagnosis of gigantism

It is possible to determine the development of gigantism by visual examination of the child, as well as by studying his anamnesis (analysis of the dynamics of weight gain and length).

To make an accurate diagnosis and identify the causes of the disease, a number of diagnostic studies are used:

• blood test for the level of STH (somatotropic hormone),
• skull x-ray,
• computed and magnetic tomography of the brain are performed to study the size of the pituitary gland and the presence of tumors and adenomas in the gland,
• radiography of the hands determines bone age,
• The ophthalmologist during the examination checks the breadth of vision and the presence of congestion in the fundus.

Complications

Gigantism, identified in a timely manner, does not pose a particular danger to the child's body. However, in the absence of adequate treatment, serious complications are possible:

• male and female infertility,
• development of brain cancer
• hormonal disruptions leading to diabetes and other diseases of the endocrine system,
• dysfunction of the kidneys, pancreas and other organs of internal secretion,
• development of heart and / or renal failure.

An important aspect of the disease, characteristic of adolescence, is the complication of communication and communication with peers and other people. Children are embarrassed by their appearance, become a target for ridicule. For this reason, a small person can withdraw into himself, become secretive. Psychological problems can also seriously complicate the future life of a student.

Treatment

What can you do

Parents with an active increase in the size of the child should inform the pediatrician about this. In any matter relating to children's health, it is much safer to be overly worried than to attribute all changes to physiological processes.

If your son or daughter complains about changes in their condition, then in no case block the symptoms with the help of traditional medicine. Her methods are powerless before gigantism. Only timely diagnosis and treatment of anomalies by professionals can completely save the child from the disease.

Only treatment prescribed by a specialist under the regular supervision of a doctor is the basic rule for the parents of a small patient.

During puberty, any differences from peers are especially acutely perceived. Be open and honest with your child. Close friendships with parents will help your teenager survive all the moral difficulties associated with shyness and ridicule from classmates.

In severe cases, you should contact a psychologist who will help restore children's confidence and set him up for positive.

What does a doctor do

When determining gigantism in appearance, the doctor will still do a number of additional studies that will allow him to determine the exact diagnosis and identify the causes of its development.

With the development of gigantism, various methods of therapy are used.

• The introduction of drugs that inhibit the development of growth hormones, the appointment of sex hormones that accelerate the process of closing the bone growth zone,
• Chemotherapy, radiation or surgery are indicated for tumors and adenomas of the pituitary gland,
• Orthopedic correction and plastic surgery can correct partial and half gigantism in a child,
• Combined treatment is the most effective, as it includes various types of therapy, which allows increasing the efficiency of anomaly elimination.

Prevention

There are no special preventive measures to prevent childhood gigantism. Most often it develops due to autoimmune abnormalities. To maintain the immunity of the child, parents should follow the rules for strengthening and maintaining children's health.

In the event of a sharp jump in height and body weight, the manifestation of other symptoms of the disease, you should immediately contact a pediatrician and endocrinologist.

In the article you will read everything about the methods of treating such a disease as gigantism in children. Specify what effective first aid should be. How to treat: choose drugs or folk methods?

You will also learn how untimely treatment of gigantism in children can be dangerous, and why it is so important to avoid the consequences. All about how to prevent gigantism in children and prevent complications.

And caring parents will find on the pages of the service full information about the symptoms of gigantism in children. How do the signs of the disease in children at 1.2 and 3 years old differ from the manifestations of the disease in children at 4, 5, 6 and 7 years old? What is the best way to treat gigantism in children?

Take care of the health of your loved ones and be in good shape!

is a pathological process or otherwise a disease characterized by a disproportionate growth of bones, cartilage, and other tissues of the body. The disease occurs in adults and is caused by increased production of growth hormone - somatotropin. It occurs in both men and women.

Gigantism- this is the same pathological process in which the concentration of growth hormone in the blood is increased, but appears much earlier in childhood. It occurs mainly in adolescence, when all endocrine systems are activated and there is an increased development of the body and differentiation of the sexes.
The difference between gigantism and acromegaly is that with gigantism, organs, tissues, and especially bones of the skeleton grow proportionally quickly. This is due to the fact that during adolescence, there is still cartilage in the bones, due to which the bone grows evenly in length and breadth. It is customary to talk about gigantism when a person's height exceeds 2 - 2.05 meters.

At a more adult age, after about 25 years, the bones are already fully formed almost everywhere. If, starting from this period of life, there is an increase in the secretion of somatotropin, then those organs where cartilage tissue predominates will undergo development: lips, ears, nose, and also internal organs.

Anatomy and physiology of the central endocrine organs

Briefly, the endocrine system consists of the central organs that regulate the functioning of the peripheral organs of the endocrine system. Above all this is the central nervous system, without the influence of which, organs and organ systems, as a whole organism, are not able to work smoothly and perform the necessary functions.
The endocrine system is so called from the fact that hormones are synthesized and released directly into the blood.

Hormones- these are biologically active substances, under the influence of which the metabolism, maintenance of normal blood pressure, bone mineralization, sexual development, and much more.
The central organs of the endocrine system are the hypothalamus and the pituitary gland. They make up a small part of the brain. The pituitary gland is located in the bony recess of the skull called the Turkish saddle, and the hypothalamus is above it. There is a close relationship between the hypothalamus and the pituitary gland. In the hypothalamus, specific releasing factors are released - biologically active substances that stimulate (liberins) or depress (statins) the work of the pituitary gland. The pituitary gland, in turn, also synthesizes hormonally active substances, under the influence of which are peripheral organs and systems.

Causes of gigantism and acromegaly

1. The first is directly related to the pathology of the pituitary gland, which produces growth hormone in large quantities. This may be a tumor of the pituitary gland, or its growth and increase in volume under the stimulating effect of the hypothalamus, and, accordingly, the functional activity also increases.
2. The second category of causes is associated with diseases that are not directly related to the pituitary gland, but due to their proximity, they compress the pituitary gland tissue and thereby disrupt its functions. Thus, there is an increase in the synthesis of growth hormone. These include tumors located nearby in the brain, or metastases (spread) of tumors from various internal organs. More often it happens with cancer of the lungs, pancreas, mammary glands, ovaries.

Symptoms of acromegaly disease

• With a predominant violation of the functions of internal organs, and excessive development of bone and cartilage tissue
• With a predominance of compression syndrome. When a pituitary tumor compresses the surrounding soft tissues of the brain. The brain is located in a closed bone space - the cranium, so any slightest increase in pressure here will manifest itself in pain, endocrine disorders. And there will also be neurological disorders and mental disorders.

Violations of the normal development of internal organs, manifests itself in their exorbitant increase in size. Observed:

• Cardiomegaly (enlargement of the heart). Often associated with high blood pressure. Patients complain of headaches mainly in the back of the head, pain around the eyes, a feeling of palpitations in the left half of the chest.
• An increase in the size of the abdominal organs: stomach, liver, spleen, intestines. There are signs of digestive disorders, such as: pain in the abdomen, constipation, bloating, heartburn, frequent belching, and others.
• The skin is thickened, there are many folds on the face. The sebaceous glands work hard, so the patient often develops acne in the face.
• Characterized by an increase in the tongue, which interferes with chewing food and a clear pronunciation of words.
• The voice gradually changes due to the growth of the vocal cords and a decrease in the lumen of the larynx in this place.

• Lengthening of the limbs of the arms and legs. Excessive growth of the legs, with a combination of a fragile bone frame and increased load, cause the appearance of a curvature in the area of ​​the knee joints. The legs become X-shaped. Increase in size and thicken the hands, feet.
• Obvious changes in the structure of the bones of the face and skull.
• Strengthening the growth of the joints of the lower jaw is manifested by the characteristic appearance of the patient. The lower jaw is strongly pushed forward and down.
• The brow ridges are enlarged. The bones of the skull are deformed.
• The bones and cartilages of the nose, increasing in size, are deformed.
• The increased growth of the upper and lower jaws causes the appearance of obvious gaps between the teeth (diastema).

• Pain that is permanent and localized in the region of the superciliary arches and around the eyes.
• Visual disturbances. It often manifests itself in the form of a narrowing of the visual fields. The patient sees everything as through a telescope. This symptom is caused by compression of the optic nerves at the point where they intersect with each other.
• Weakness, increased fatigue.
• Symptoms of increased intracranial pressure are rare and manifest as widespread headaches, nausea, and vomiting.

• Increased sweating
• The number of heartbeats increases
• The patient becomes nervous and irritable

Hormonal disorders of the functions of the genital organs are manifested:

• In women - menstrual dysfunction. Menstruation becomes rare, and even may disappear altogether. In some cases, milky discharge from the mammary glands is observed.
• In men, it manifests itself in the form of a decrease in potency and sexual desire.

Diagnosis of acromegaly and gigantism

In later periods, the appearance of a violation of the release of growth hormone synthesis leads to partial changes in the skeleton and is manifested mainly by coarsening of facial features, increased hair growth, and the appearance of endocrine disorders. In such cases, the diagnosis is acromegaly.

To clarify the diagnosis in both cases, it is necessary to find out the quantitative content of growth hormone in the blood. Norms vary by age and gender.

Biochemical analyzes
They show an increase in the amount of total protein in the body is normal (65-80 grams), an increase in the concentration of glucose in the blood is normal (3.5-5.5 mmol / l). These changes are nonspecific and may also increase in other diseases.
Diagnostic samples

• A glucose test shows whether there are disorders of the pituitary gland or not. Normally, after drinking a glass of water with sugar, there is a decrease in the amount of growth hormone in the blood. With gigantism of a tumor nature (origin), the level of growth hormone is constantly elevated, regardless of the hormonal background in the body and other influences, external and internal factors.
• Determining the level of somatomedins reflects the activity of somatotropic hormone.

Laboratory tests to check the concentration of hormones in the blood, carried out using radioimmunological or enzyme immunoassay methods. If there are additional symptoms associated with disruption of the peripheral endocrine glands (thyroid gland, adrenal glands, ovaries in women, or testicles in men), the amount of the corresponding hormones in the blood is measured.

• In case of dysfunction of the thyroid gland, the concentration of thyroxine (T4), triiodothyronine (T3), as well as the level of pituitary thyrotropic hormone (TSH), under the influence of which the thyroid gland itself is
• With a delay in sexual development, impotence, menstrual irregularities, studies are carried out on the content of sex hormones: testosterone in men, estrogen and progesterone in women.

In doubtful cases, studies are carried out using nuclear magnetic resonance (NMR).

Ophthalmic examination
In cases of visual impairment, the appearance of pain in the orbits, it is necessary to seek help from an ophthalmologist. With the help of special devices, the ophthalmologist will determine the condition of the fundus (edema, hemorrhage), and also measure the width of the visual fields, which in some cases may narrow.

Treatment of gigantism and acromegaly

In the presence of complications from other organs and systems, symptomatic agents are used.
The treatment is carried out both with drugs and radiotherapy.
Drug treatment is based on the inhibition of the production of somatotropic hormone by the pituitary gland. The main drugs are:

• Somatostatin (octreotide)- a synthetic analogue of a natural hormone that inhibits growth. The main value is the inhibition of the synthesis of somatotropic hormone. There is also a good hemostatic effect in intragastric and intra-intestinal bleeding.

• Bromocriptine (parlodel)- the drug simulates special receptors in the brain responsible for the production of the biologically active substance dopamine. Dopamine, in turn, inhibits the synthesis of growth hormone.

The drug is taken in small doses under the control of laboratory indicators of the level of hormones in the blood, as well as under the supervision of an endocrinologist.

X-ray therapy- a method of treatment based on the use of highly active X-ray waves, which are able to suppress tumor growth and reduce the production of growth hormone.
Heading doses of radioactive radiation are prescribed by a doctor depending on the size and degree of activity of the tumor process.

Surgery used in cases where the size of the tumor exceeds the allowable limits, there is also a significant compression of the surrounding tissues of the brain and the appearance of symptoms of increased intracranial pressure. The surgical method is resorted to when conservative treatment does not give positive results.

Prevention of acromegaly

• Preventive measures are reduced to the timely detection of symptoms of premature enhanced growth of the body.
• Seek help from an endocrinologist at the first sign of illness.
• Nutrition for children and adults should be complete and contain all the necessary healthy ingredients.
• Timely treat concomitant infectious and inflammatory diseases of the central nervous system.
• Prevention of injuries in the head area.
• With the detected pathology of the pituitary gland, timely treatment will not allow the pathological development of the disease.
• During treatment, it is necessary to constantly monitor the level of growth hormone in the blood, to be monitored by a specialist in endocrinology, as well as by an ophthalmologist at least once every six months.

Excess of what hormone can cause acromegaly?

On the body of an adult, this hormone acts as follows:

• stimulates protein synthesis, and also stops its destruction;
• increases the rate of fat burning;
• reduces body fat;
• increases muscle mass relative to fat;
• raises blood glucose levels.

• hormone somatoliberin ( produced in the hypothalamus);
• the hormone ghrelin produced in the gastric mucosa and hypothalamus);
• physical activity;
• low blood glucose ( hypoglycemia);
• increased production of androgens during puberty.

Excessive proliferation of pituitary gland cells subsequently leads to the development of a benign tumor ( adenomas), in which acromegaly develops. It should be noted that with pituitary adenoma, acromegaly can only be caused by increased production of somatotropic hormone.

The development of pituitary adenoma can contribute to:

• brain injury;
• acute or chronic infectious diseases ( e.g. malaria, meningitis, tuberculosis);
• pathological course of pregnancy and childbirth;
• long-term use of hormonal contraceptives.

• an increase in the size of the head;
• an increase in the size of the ears, lips, tongue, nose and lower jaw;
• an increase in the size of the arms and legs ( especially stop);
• decreased sensitivity of the upper and lower extremities;
• increased weakness and fatigue;
• dull headaches;
• decrease in the field of view;
• skin change ( there is coarsening of the skin, increased sweating, papillomas and warts appear);
• pronounced growth of hair on the body and face.

For the diagnosis of diseases associated with impaired secretion of somatotropic hormone, a blood test is widely used. This analysis allows you to determine the lack or excess of growth hormone in the human body.

The following tests are used to study the level of somatotropic hormone:

• Suppression test. Determines the excess hormone in the blood. Twelve hours before the study, food intake should be excluded. In the office on the day of the study, before taking the test, the patient will need to ingest the prescribed amount of glucose solution. After that, at certain intervals, the patient will take a blood sample for the subsequent determination of the level of somatotropic hormone. The accepted glucose in this case will indicate how much the work of the pituitary gland and the production of growth hormone by it are suppressed. If, after consuming the solution, the level of the hormone remains high, then this means that the pituitary gland is producing an increased production of this hormone.
• Stimulation test. Determines the lack of growth hormone in the blood. Twelve hours before the study, food intake should be excluded. On the day of the study, blood is taken from the patient, then a special drug is administered intravenously to stimulate the production of somatotropic hormone ( e.g. insulin, clonidine, arginine). Subsequent blood sampling takes place at certain intervals, the level of the hormone in the blood is determined and the extent to which the administered drug provokes its production in the pituitary gland is revealed.

Is a pituitary adenoma the cause of acromegaly?

A pituitary adenoma is a benign tumor characterized by the growth of cells of the anterior lobe of the gland.

Currently, there is the following classification of pituitary adenoma:

• hormonally active;
• hormonally inactive does not produce a hormone);
• malignant ( extremely rare).

• somatotropinoma (increased production of the somatotropin hormone);
• corticotropinoma (increased production of adrenocorticotropic hormone);
• prolactinoma (increased production of lactotropic hormone);
• thyrotropinoma (increased production of thyroid-stimulating hormone);
• gonadotropinoma (increased production of follicle-stimulating hormone).

The concept of acromegaly comes from Greek words and means the following:

• « acron"- limb;
• « megalos" - increase.

There are the following signs of a pituitary adenoma:

• decreased vision;
• lack of menstruation;
• severe sweating;
• headache;
• weakness;
• increased fatigue.

• enlargement of the nose;
• the appearance of cheekbones;
• increase in superciliary arches;
• change in bite;
• divergence of teeth;
• an increase in the size of the arms and legs;
• pain in the limbs.

Depending on the size of the adenoma, there are:

• picoadenoma (the size of the tumor does not exceed three millimeters);
• microadenoma (the size of the tumor reaches ten millimeters);
• macroadenomas (the size of the tumor is more than ten millimeters);
• giant adenomas (tumor size from forty to fifty millimeters or more).

• type of tumor;
• adenoma size;
• the severity of the course of the disease;
• the general health of the patient;
• patient's age.

Also, in the treatment of this disease, radiation and drug therapy is widely used ( hormonal preparations) therapy.

What is the pathogenesis of acromegaly?

An increase in the production of this hormone can contribute to:

• disruption of the pituitary gland;
• disruption of the hypothalamus.

Acromegaly is a sluggish disease and is characterized by a gradual increase in symptoms. Initially, the patient has coarsening of facial features, enlargement of the nose, ears and lips. Then the skull, lower jaw, as well as hands and feet begin to increase in size. The person himself may not notice the changes occurring in appearance and consult a doctor only a few years after the onset of the disease.

There are the following reasons that can provoke the formation of a pituitary adenoma:

• brain injury;
• infectious diseases ( e.g. meningitis, encephalitis, brucellosis);
• long-term use of oral hormonal contraception;
• pathological course of pregnancy.

The size of a pituitary tumor can vary from a few millimeters to several centimeters. With a later period of flow, the increased size of the pituitary gland begins to compress the surrounding areas of the brain, including large vessels and nerves. In this regard, a person begins to develop eye ( e.g. decreased visual acuity, reduced visual field), neurological ( e.g. elevation, headache) and other symptoms.

Disruption of the hypothalamus
The hypothalamus together with the pituitary gland form the hypothalamic-pituitary complex, in which the hypothalamus controls the production of pituitary hormones.

Hormones secreted by the hypothalamus are divided into the following groups:

• releasing hormones. This group includes seven hormones that activate the production of hormones of the anterior pituitary gland. This includes hormones such as prolactoliberin ( stimulates the secretion of prolactin), thyroliberin ( stimulates the secretion of thyroid-stimulating hormone), somatoliberin ( stimulates the secretion of growth hormone) and others.
• Statins. These hormones, on the contrary, inhibit the production of hormones from the anterior pituitary gland. These include somatostatin ( suppresses the secretion of growth hormone), prolactostatin ( suppresses the secretion of prolactin) and melanostatin ( inhibits the secretion of melanotropin).
• Hormones of the posterior pituitary gland. The hypothalamus produces hormones such as oxytocin and vasopressin, which are then released to the pituitary gland.

If the hypothalamus is malfunctioning, a person may experience the following symptoms:

• obesity;
• sleep disturbance ( increased drowsiness);
• change in thermoregulation ( an increase in body temperature above normal, less often its decrease);
• increased appetite;
• hypodynamia ( reduced motor activity);
• diabetes insipidus;
• psychoemotional disorders;
• increased hair growth on the body and face.

What are the stages of acromegaly?

• preacromegaly;
• hypertrophic;
• tumor;
• cachexia.

• mild severity;
• medium severity;
• severe degree.

According to the activity of the process, acromegaly can be:

• active;
• inactive.

• benign;
• malignant.

How to treat acromegaly with folk remedies?

That is why it is not recommended to treat acromegaly with alternative methods, and if symptoms of the disease appear, you should seek help from a specialist as soon as possible. The attending physician will prescribe the necessary studies, identify the cause of the disease, and prescribe the appropriate treatment. Treatment for this condition may include medication ( e.g. somatostatin analogues, dopamine receptor agonists), surgical intervention ( with pituitary adenoma), as well as radiation therapy.

With acromegaly, a person may experience the following symptoms:

• gradual increase in limbs of the body ( e.g. nose, chin, ears, feet and hands);
• an increase in the size of internal organs;
• visual impairment;
• violation of the menstrual cycle in women;
• infertility;
• weakness;
• increased fatigue;
• voice change ( getting rougher);
• skeletal change ( for example, widening of the intercostal spaces, curvature of the spinal column);
• increased sweating;
• respiratory failure.

What facial changes are observed in acromegaly?

With acromegaly, the patient has an increase in:

• nose
• ears;
• superciliary arches;
• cheekbones;
• language;
• chin.

The skin on the face coarsens, becomes more edematous and dense. Due to the increase in the size of the sweat and sebaceous glands in humans, there is an increased secretion of sweat and sebum. These changes subsequently lead to the formation of rough and deep folds on the face, drooping of the eyelids and thickening of the lips ( especially the lower lip). In addition, warts and papillomas may appear on human skin.

Also, due to the changed hormonal background, the patient increases hair growth both on the body and on the face. So in women with acromegaly, increased growth of mustaches and beards can be observed.

With acromegaly, the patient may also experience the following symptoms:

• headache, usually in the temporal and frontal regions;
• increased intracranial pressure;
• decreased visual acuity;
• decrease in the field of view;
• hearing loss;
• an increase in the size of the limbs and internal organs;
• weakness;
• decrease in working capacity;
• violation of the menstrual cycle;
• infertility.

• skulls;
• Turkish saddle ( recess in which the pituitary gland lies);
• lower jaw;
• paranasal sinuses;
• cheekbones;
• superciliary arches;
• occipital protuberance.

What drugs are prescribed for acromegaly?

• early stage of the disease;
• refusal of the patient to undergo surgical treatment;
• the presence of contraindications for surgical intervention or radiation therapy;
• low efficiency of radiation therapy.

• somatostatin analogues;
• dopamine receptor agonists.

Somatostatin analogues can be used when treatment of the disease with dopaminomimetics is ineffective.

• Sandostatin;
• Somatulin.

Taking these drugs can cause the following side effects:

• loss of appetite;
• nausea and vomiting;
• stool disorder diarrhea, fatty stools);
• disruption of the liver;
• increased levels of bilirubin;
• allergic reactions;
• hyperglycemia or hypoglycemia.

Dopamine receptor agonists
Hormonal drugs from this pharmacological group stimulate dopamine receptors and reduce the production of the anterior pituitary gland of the hormone prolactin. Also, these drugs reduce the production of growth hormone, so they are widely used in the treatment of acromegaly, especially in conjunction with radiation therapy or surgery.

With acromegaly, the following drugs can be prescribed:

• Parlodel;
• Abergin;
• Norprolac.

• thirst;
• nausea or vomiting;
• stool disorder constipation);
• dizziness and headache;
• severe weakness;
• increased drowsiness;
• allergic reactions;
• feeling of coldness in the extremities;
• increased psychomotor activity;
• disturbance of consciousness.

• Surgery. To remove a pituitary adenoma, surgery is effectively used, in which the tumor is removed using endoscopic instruments. The results of studies show that if the size of the adenoma was up to one centimeter, then 90% of patients reached remission after surgery. If the tumor is larger than one centimeter, then it can be removed in two stages.
• Radiation therapy. This method consists in the fact that the affected area of ​​the pituitary gland is exposed to irradiation with gamma rays or a proton beam. Radiation therapy can be used simultaneously with surgical treatment or alone. Treatment usually includes four courses of radiation under regular monitoring of research results.

Does acromegaly affect pregnancy?

The clinical picture of acromegaly includes an increase in the size of the limbs ( e.g. hands, feet, nose, chin) and internal organs, neurological ( e.g. weakness, fatigue, headaches) and ophthalmic ( e.g. decreased visual acuity) symptoms.

Also in women, this disease causes the following changes:

• menstrual irregularity (up to the absence of menstruation - amenorrhea);
• galactorrhea (a pathological condition in which there is a release of milk from the mammary glands);
• infertility.

After the onset of pregnancy, during its normal course, the pituitary gland undergoes a number of changes. For example, under the action of sex steroids of the placenta, hyperplasia of prolactin-secreting cells occurs ( lactotrophs) and increased prolactin levels. Also, a woman has an increase in the concentration of growth hormone. At the same time, the body suppresses the production of follicle-stimulating and luteinizing hormones. The size of the pituitary gland by the end of pregnancy can increase two to three times. All these changes are physiological, and the body of a pregnant woman easily adapts to them, which guarantees the child protection and normal development.

However, it should be noted that if the body of a pregnant woman weakens and fails, then a woman in this period can be diagnosed with an exacerbation of a previously treated disease or the development of a new one ( e.g. pituitary adenoma).

In a woman, infertility with acromegaly may be associated with a hormonal disorder in the work of the hypothalamus-pituitary-ovaries complex. However, with adequately selected treatment of the disease, the ability to conceive in women after therapy, as a rule, returns.

If acromegaly began to develop during pregnancy, or conception occurred during the period of the disease, then an increased level of somatotropic hormone can affect the health of the mother to a greater extent than the fetus, since this hormone is not able to pass through the placental barrier.

Treatment of acromegaly during pregnancy is set individually and depends on the following factors:

• the severity of the disease;
• general condition of the pregnant woman;
• pituitary adenoma size.

In 30% of men, acromegaly causes erectile dysfunction, that is, it leads to the development of impotence.

What is partial gigantism?

Currently, the following causes are distinguished that can lead to the development of partial gigantism:

• Mechanical. Due to the incorrect position of the fetus in the uterine cavity, compression of certain parts of the body, for example, by the umbilical cord, can occur. This may lead to the development of stagnation and subsequently an increase in the size of the compressed area.
• Embryonic. During fetal development, there may be a violation of the formation of body structures ( for example, incorrect laying of the bone or vascular systems), which can eventually lead to increased growth of certain parts of the body.
• Nervous-trophic. It is characterized by neurotrophic changes ( e.g. damage to sympathetic fibers), in which an increase in body area can be observed.

• increase in the size of the affected area of ​​the body in length and width;
• excessive growth of soft tissues;
• external cosmetic changes in a certain part of the body.

Macrodactyly can be of two types:

• true, in which there is an increased growth of soft tissues and bones of the fingers ( metatarsal bones and phalanges);
• false, which is characterized by congenital disorders of the vascular network, as a result of which the child has an increase in toes.

Most often there is an increase in the size of the second and third fingers, which subsequently leads to an increase in the size of the entire foot. During growth, the affected fingers begin to take a forced position, bend or move apart excessively.

In the diagnosis of this disease, a visual examination of the patient is widely used, as well as an x-ray examination, in which one can see an increase in the bones of the studied area of ​​the body in length and width.

In the treatment of this disease, as a rule, surgical intervention is used, in which it can be performed:

• removal of soft tissues;
• deletion ( resection) section of the epiphyseal plate;
• partial or complete disarticulation of the fingers.

What are the signs of gigantism in children?

There are the following main reasons that can affect the increase in the level of growth hormone:

• pituitary adenoma;
• head injury;
• infectious diseases affecting the nervous system e.g. meningitis, encephalitis).

With gigantism, the following changes are observed:

• high growth;
• limb lengthening;
• disproportionately small head size;
• violation of sexual activity;
• changes in the psycho-emotional sphere;
• reduced work capacity;
• development of infertility is possible.

• increased fatigue;
• weakness;
• decreased vision;
• headache ( due to increased intracranial pressure);
• dizziness;
• numbness of the limbs;
• arthralgia ( joint pain);
• pain during physical activity;
• menstrual disorders ( until the disappearance of menstruation).

• dysfunction of the thyroid gland hypothyroidism or hyperthyroidism);
• increased blood pressure;
• heart failure;
• liver damage;
• respiratory failure.

• true, in which there is a proportional increase in the size of all parts of the body and the absence of violations of mental and physiological functions;
• partial, characterized by an increase in individual parts of the body ( e.g. toes, hands or half of the body);
• acromegalic, accompanied by a pronounced increase in limbs ( e.g. upper and lower limbs as well as nose, chin);
• splanchnomegaly, characterized by an increase in the size and mass of internal organs;
• eunuchoid in which there is a lack or underdevelopment of secondary sexual characteristics due to disruption of the sex glands;
• cerebral, accompanied by violations of the intellect due to brain damage.

• visual examination of the patient;
• laboratory research ( blood test to determine the level of somatotropic hormone);
• instrumental diagnostics ( e.g. computed tomography, x-ray, magnetic resonance imaging).

Gigantism is a pathology that develops as a result of hypersecretion of growth hormone (somatotropin) produced by the anterior pituitary gland, which provokes excessive proportional growth of the bones of the trunk and all limbs. This disease, as a rule, manifests itself already in childhood (at 7-13 years). In addition to rapid growth, this disease is accompanied by mental disorders, as well as disorders of the reproductive system. Patients with this diagnosis are often at risk of infertility.

Gigantism classification

According to the modern endocrinological classification, the following types of gigantism are distinguished:

• true gigantism, a characteristic feature of which is a proportional increase in all parts of the body, while the mental and functional development of the body remains normal;
• acromegalic gigantism (signs of acromegaly join);
• splanhomegaly: with this type of gigantism, there is an increase in the size and mass of internal organs, in some sources this disease is found under the name "gigantism of internal organs";
• eunuchoid gigantism, a pathology of the main feature, which is a decrease in functionality or complete dysfunction of the gonads. Such patients have practically no secondary sexual characteristics, there are disproportionately elongated limbs and open growth zones in the joints;
• partial or partial gigantism is accompanied by an increase in individual parts of the body;
• half gigantism is characterized by an increase in the body on one side;
• cerebral gigantism: associated with an organic disorder of the brain and entails mental disorders.

Causes of gigantism

The underlying cause of gigantism is the excessive production of somatotropin, which in turn can be provoked by the following pathologies:

• intoxication (increased level of toxins in the body);
• neoplasms of the adenohypophysis;
• traumatic brain injury;
• neuroinfections - infectious (bacterial or viral) diseases of the central nervous system, such as encephalitis, meningitis, meningoencephalitis.

In addition to all of the above, gigantism can be caused by a low level of sensitivity of epiphyseal cartilage receptors (the area of ​​the bone from which it grows in length) to hormones responsible for sexual development, this provokes the ability of bones to grow (bone growth zones remain open), even after end of puberty (7-13 years).

Gigantism Symptoms

The main symptom of gigantism is a significant increase in body parts. As a rule, the main growth spurt occurs in childhood (10-15 years). In patients, high growth rates are noted, which are unusual for the normal physiological development of the human body. Patients have subjective complaints of headaches, dizziness, increased fatigue, pain in the bones and joints, decreased vision. The deterioration of memory and performance leaves imprints on school performance.

Gigantism is accompanied by neuropsychiatric disorders, as well as sexual dysfunctions (ifantilism). In men with gigantism, hypogonadism develops, in women - early cessation of menstrual function or amenorrhea, as well as infertility. Among other hormonal pathologies that can be symptoms of gigantism, there are:

• sugar;
• diabetes insipidus;
• hyperhypothyroidism.

Gigantism is initially manifested by an increase in muscle mass, and then muscle weakness and asthenia occurs.

Diagnosis of gigantism

The diagnosis of "gigantism" is established based on the visualization of clinical manifestations. Such patients are shown to conduct x-ray studies, neurological and ophthalmological diagnostics. Laboratory diagnostics is uninformative, insofar as it shows only one deviation - an increased level of somatotropin. Patients with suspicions of such a pathology are shown to have computed tomography of the brain, because often the cause of gigantism is the presence of tumor-like formations in the pituitary gland.

With a growing adenoma (benign tumor) of the pituitary gland, an increase in the Turkish saddle (the area of ​​\u200b\u200bthe skull where the pituitary gland is located) is noted. A growing adenoma can contribute to the limitation of visual fields (reduced vision). X-ray diagnostics helps to identify the lag of physiological bone growth from the passport one.

If, after the maturation of the skeleton, the production of somatotropin does not stop, acromegaly is formed.

Complications of gigantism

Gigantism is dangerous with complications in the form of acromegaly, infertility and, in some cases, mental disorders. It is also possible the appearance of concomitant pathologies: heart failure, arterial hypertension, dystrophic changes in the liver, emphysema, thyroid dysfunction and the development of diabetes mellitus.

Treatment of gigantism

The treatment of gigantism is similar to that of acromegaly. Basically, treatment regimens depend on the form of gigantism.

The main principles of treatment of gigantism in modern conditions are the combination of hormonal drugs and X-ray therapy, as a rule, such measures give a positive result.

To normalize the level of growth hormone in this pathology, sex hormones are used to close growth zones and somatotropin analogues.

Often the treatment of gigantism is aimed at eliminating etiological factors (removal of pituitary adenomas, radiation treatment in combination with drug therapy with dopamine antagonists).

With the eunuchoid form of gigantism, a complex of therapeutic measures will be aimed at inhibiting the further growth of the skeleton, accelerating its ossification and eliminating infantilism.

With partial gigantism, in addition to the main treatment, it is necessary to take a set of measures aimed at orthopedic correction through plastic surgery.

Forecast and prevention of gigantism

With adequate and appropriate treatment, this disease has a relatively favorable prognosis. But the life expectancy of patients is significantly shortened due to the development of intercurrent pathologies (diseases that complicate the course of other diseases), which are the main causes of death of patients with gigantism in people. The majority of patients suffer from infertility and have a very low level of ability to work.

Unfortunately, there is no set of measures to prevent gigantism yet. Parental attention to the development of the child during puberty is very important. If the slightest symptoms appear, you should immediately seek specialized medical help. Timely diagnosis and treatment will help prevent the development of complications.

A disease that is accompanied by pathological changes in the pituitary gland. The pituitary gland is the growth hormone. With violations in the hormonal gland, the growth of the body and body occurs.

Mostly violations concern the anterior lobe of the pituitary gland. Usually the etiology of the disease is unknown. One can only speculate about the possible causes of the pathology.

The disease develops in childhood and adolescence. What is most indicative of a hereditary disorder. If the disease is congenital, then the cause is in gene disorders.

The course of the disease depends on many factors. With an uncomplicated course of the disease, clinical signs practically do not appear.

The course is progressive. That is, the absence of complications can be only at the initial stage of the disease. The person then continues to grow throughout life. Or up to thirty.

Rapid growth contributes to changes in muscle mass. It usually develops poorly. Or it develops normally.

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Diagnostics

Gigantism can be diagnosed by taking anamnesis. This allows you to determine the likely causes of the disease.

An external inspection is being carried out. Examination allows you to make the most accurate diagnosis. Since the external signs of the disease are able to suggest gigantism.

Laboratory studies are also very relevant. Blood diagnostics allows you to identify deviations in the production of somatotropic hormone. It's directly growth hormone.

X-rays are useful to determine pituitary disorders. X-ray of the skull allows you to determine the presence of a tumor in the pituitary gland.

For more detailed information, an MRI of the brain is performed. What will determine the disease more significantly. In addition, the brain determines pathological changes in other parts of the brain.

Hands with gigantism have an unusual length, so it is advisable to take an x-ray of the hands. A visual inspection will not be enough.

X-ray of the hands will determine the pathological length. They do not correspond to the age of the patient.

Prevention

It is important to show anxiety at an early stage in the development of the disease. Because the further, the worse.

Prevention of gigantism will consist in the early detection of the disease. Timely examination and treatment will prevent possible complications.

If the disease is caused by a pathology of the pituitary gland or a tumor. It is important to have surgery. This will help prevent growth hormone disorders.

If gigantism is caused by various injuries, then it is important to carry out non-specific prophylaxis. It will be to avoid brain injury.

Meningitis is an infectious process. The causative agent is meningococcus. Since meningitis causes gigantism, it is important to prevent the development of meningitis.

If gigantism is caused by intoxication, then it is important to prevent various kinds of poisoning. It could be chemical poisoning. And also food.

Treatment

The following drugs are used to treat gigantism:

• hormonal;
• medical;
• radiation treatment;
• surgical intervention.

In order to normalize the function of growth hormone, it is necessary to apply hormone treatment. It allows you to achieve significant results.

Sex hormones are also used in the treatment of the disease. What is important in the treatment of acromegaly. Or gigantism.

Somatostatin analogues are used. Used to influence bone growth.

Radiation therapy is used in cases where a tumor is present. Tumor directly in the pituitary gland.

A pituitary adenoma is removed by surgical methods. That allows you to stop the growth and formation of metastases.

With surgery, it is important to apply medical treatment. It allows you to speed up the healing process.

In adults

Gigantism in adults is often manifested by various hormonal disorders. Sex hormones are often affected. That is, the violation is directly related to sexual function.

In women, there is often a lack of menstruation. There may also be an earlier cessation of menstruation.

All this is reflected in the reproductive function. This means that the woman is infertile.

Men also experience hormonal imbalances. Sexual function suffers. Infertility may develop.

In adults with gigantism, performance is noticeably reduced. This is due to muscle weakness. Asthenia develops.

Various complications may develop. And all of them are the cause of hormonal disorders. Complications include:

• not diabetes;
• hyperthyroidism;
• diabetes.

In children

Gigantism in children develops at the stage of growth of the body. That is, when the ossification of the skeleton has not yet been completed.

Teenagers are more commonly affected. That is, children at the stage of puberty. Age from 10 to 13 years.

The child is growing too fast. The process is quite intense. May continue throughout childhood. Up until puberty.

In children, the disease is quite rare. Gigantism is a strange disease. Usually parents do not have gigantism.

Boys suffer from gigantism more often than girls. The most responsible period is the age from 11 to 15 years. During this period, growth is most intensive.

This disease affects the sexual development of the child. Leads to infertility. Boys and girls.

The child begins to tire quickly. This affects the learning process. Children with gigantism are characterized by poor performance in school.

Forecast

Much depends on the treatment process. As well as associated diseases.

With adequate treatment with the use of radiation and surgical intervention, the prognosis is favorable.

But this is the case if gigantism is caused by a pituitary adenoma. If it is an injury, then it is advisable to prescribe drug therapy.

An unfavorable prognosis is observed with inadequate treatment. If the treatment was not carried out on time.

Exodus

More often than not, gigantism ends in death. Since the course of the disease is usually chronic. And there are various kinds of complications. Up to heart failure.

Sick people do not live to a ripe old age. But there are exceptions! This is in the case of timely treatment. The use of hormonal, radiation therapy. That is an integrated approach to the disease.

If you often see an endocrinologist. Follow all doctor's recommendations. This can prevent the development of gigantism. Then the outcome of the disease will be favorable.

Lifespan

Gigantism directly affects the quality of life. A person cannot normally coexist in society. His ability to work was significantly impaired.

But this fact may not affect life expectancy. If a person complies with the principles of treatment.

The sooner we diagnose the disease and begin treatment. The higher the probability of increasing life expectancy!