Sunday, 21 October 2007

Acromegaly




clinical presentation of acromegaly result from:

1-excess growth hormone.

2-pituitary tumour (bitemporal hemianopia & headache)

3-compression of adjacent normal putuitary (hypoputuitrism due to diminshed ant pit production corticotropins,gonadotropins and thyrotropins))

on examination:

  1. Generalized coarse features of the face
  2. Soft tissue enlargement of nose ,tounge and ears
  3. Promenant supraorbital ridges
  4. Proganthism
  5. Increase interdental space
  6. Malocclusion
  7. Kyphosis
  8. Husky voice
  9. Spade like fingers
  10. Moist rubbery skin

What other physicl signs that may be present?

increase foot/hat size

bowed legs

rolling gate

goitre

gynaecomastia

galactorrhea

large testicles

multiple skin tag

acanthosis nigricans

OA

Carpel tunnel


What are the indications of disease activity?

  1. Headache
  2. Exessive sweating
  3. Skin tag
  4. Glycosurea
  5. ↑BP
  6. ↑Loss of visual field

what are the investigations?

Biochemical:


GTT→failure to suppress GH

Plasma IGF-1

Ca (to exclude MEN I in 5% of patients)

Basal and Dynamic pit function test(ACTH,TSH and LH/FSH)


Radiological:

MRI od pit fossa

Skull X-ray

Other:

Formal Goldman perimetry

Compare photo’s


What are the line of management?

1-Trans sphenoidal surgery: first line therapy

2-Irradiation: slow biochemical response

3-Medical:

somatostatin analogues →octeriotide

Dopamine agonist →bromocriptine

growth hormone antagonist→Pegvisomant


What are the most common cause of death?

Cardiac failuer

Tumour expansion (mass effect and bleed)

↑BP

degenerative vascular disease


what are the complcations?

Cardiomyopathy

BP

Impaired glucose tolerance

Artheritis

Visual field defect

Large bowel tumour (10 fold increased risk)



click here to read more about acromegaly

44 comments:

  1. what's proganthism?

    ReplyDelete
  2. Proganthism is Protrusion of the lower jaw.

    ReplyDelete
  3. Testicles are small in Acromegaly because of accompanied Hypogonadism

    ReplyDelete
  4. I must thank you for the efforts you have put in penning this blog.
    I'm hoping to view the same high-grade content from you later on as well. In truth, your creative writing abilities has encouraged me to get my own blog now ;)

    My website how to improve eyesight

    ReplyDelete
  5. Wonderful site you have here but I was curious about if you
    knew of any user discussion forums that cover the
    same topics discussed here? I'd really like to be a part of community where I can get suggestions from other experienced people that share the same interest. If you have any suggestions, please let me know. Cheers!

    my page - how to lose belly fat

    ReplyDelete
  6. I am sure this paragraph has touched all the internet viewers, its really really
    good post on building up new blog.

    my site - How To Lose Belly Fat

    ReplyDelete
  7. Hey I am so grateful I found your web site, I really found you by mistake, while I was looking
    on Google for something else, Anyhow I am here now and would just like to say kudos for a fantastic post and a all
    round exciting blog (I also love the theme/design), I don't have time to look over it all at the moment but I have book-marked it and also added in your RSS feeds, so when I have time I will be back to read a lot more, Please do keep up the awesome job.

    Look at my web-site; Starcraft 2 Hack

    ReplyDelete
  8. Hello mates, its wonderful post on the topic of teachingand fully
    explained, keep it up all the time.

    my web page: World of tanks hack

    ReplyDelete
  9. My family members always say that I am wasting my time here at
    web, but I know I am getting knowledge daily by reading
    such nice posts.

    my web site ... tattoo removal cream reviews

    ReplyDelete
  10. I delight in, cause I found just what I used to be taking a look for.
    You've ended my four day long hunt! God Bless you man. Have a nice day. Bye

    Here is my web site - unknown

    ReplyDelete
  11. This text is worth everyone's attention. Where can I find out more?

    Have a look at my web site :: Unknown

    ReplyDelete
  12. I got this web site from my buddy who told me on the topic of this website and now this time I
    am visiting this website and reading very informative articles or reviews here.


    my web site ... How To Get Microsoft Points

    ReplyDelete
  13. Pretty section of content. I just stumbled upon your website and in accession capital to assert that I
    get in fact enjoyed account your blog posts.
    Any way I will be subscribing to your augment and even
    I achievement you access consistently rapidly.


    My website :: Unknown

    ReplyDelete
  14. Thanks for sharing your thoughts. I truly appreciate your efforts and I will be waiting for your next post
    thanks once again.

    My site :: Stretch Marks

    ReplyDelete
  15. What's up to all, the contents existing at this web site are actually remarkable for people experience, well, keep up the nice work fellows.

    Also visit my website :: Unknown

    ReplyDelete
  16. You have made some really good points there.
    I looked on the internet for additional information about the
    issue and found most individuals will go along with your views on this site.


    my website pirater un compte facebook

    ReplyDelete
  17. You made some decent points there. I looked on the
    web for more information about the issue and found most individuals will go
    along with your views on this web site.

    Check out my homepage; Hairqnwyccnr408.Tblog.com

    ReplyDelete
  18. Thanks very nice blog!

    Also visit my web page Bestcoconutoilforhair.Com

    ReplyDelete
  19. This website was... how do I say it? Relevant!! Finally
    I've found something that helped me. Kudos!

    my weblog :: Psn Code Generator

    ReplyDelete
  20. This design is spectacular! You certainly know how to keep a reader entertained.

    Between your wit and your videos, I was almost moved to start my own blog (well, almost.

    ..HaHa!) Wonderful job. I really loved what you
    had to say, and more than that, how you presented it.

    Too cool!

    Also visit my webpage diaper rash home remedies

    ReplyDelete
  21. Hello outstanding website! Does running a blog such as this take a massive amount work?
    I have very little expertise in programming however I had been hoping to start my own blog
    in the near future. Anyway, if you have any
    suggestions or techniques for new blog owners please share.

    I understand this is off topic however I simply had to ask.
    Appreciate it!

    Here is my web site; unknown

    ReplyDelete
  22. What's up, this weekend is nice for me, as this time i am reading this enormous educational post here at my residence.

    Feel free to visit my webpage Unknown

    ReplyDelete
  23. It's appropriate time to make some plans for the longer term and it is time to be happy. I have learn this post and if I may I desire to counsel you few attention-grabbing things or tips. Perhaps you can write subsequent articles regarding this article. I desire to learn even more things about it!

    Here is my webpage :: http://Gzxjaime.momaroo.com/

    ReplyDelete
  24. I am really enjoying the theme/design of your website.

    Do you ever run into any browser compatibility problems?
    A couple of my blog audience have complained about my website not operating correctly in Explorer but looks great
    in Chrome. Do you have any recommendations to help fix this problem?


    Stop by my web-site how to jailbreak a ps3

    ReplyDelete
  25. excellent post, very informative. I ponder why the opposite experts of this sector don't realize this. You must continue your writing. I am confident, you have a great readers' base already!


    Here is my website - world of Tanks hack

    ReplyDelete
  26. Nice post. I learn something new and challenging on websites
    I stumbleupon every day. It will always be interesting to read through articles from other authors
    and use something from other web sites.

    my homepage - Unknown

    ReplyDelete
  27. Right now it seems like Movable Type is the best blogging platform available right now.
    (from what I've read) Is that what you are using on your blog?

    Here is my blog post :: coconut oil For Hair

    ReplyDelete
  28. Wonderful blog! I found it while browsing on Yahoo
    News. Do you have any suggestions on how to get listed in Yahoo News?
    I've been trying for a while but I never seem to get there! Cheers

    Check out my site :: PS3 Jailbreak 4.41

    ReplyDelete
  29. Aw, this was a very nice post. Spending some time and actual effort to produce a top notch article…
    but what can I say… I hesitate a whole lot
    and don't seem to get nearly anything done.

    Feel free to surf to my webpage; coconut oil for hair

    ReplyDelete
  30. My brother recommended I might like this blog.
    He was totally right. This post actually made my day.
    You can not imagine just how much time I had spent for this information!
    Thanks!

    Feel free to surf to my web blog: Microsoft Office Gratuit

    ReplyDelete
  31. Ahaa, its nice dialogue on the topic of this
    paragraph at this place at this weblog, I have read all that, so at this time me
    also commenting at this place.

    Visit my web site: Refinishing Hardwood Floors

    ReplyDelete
  32. Good article! We are linking to this particularly great article on
    our site. Keep up the great writing.

    my webpage - coconut Oil For hair loss

    ReplyDelete
  33. This paragraph offers clear idea in support of the new visitors of blogging, that actually
    how to do blogging.

    Here is my web page ... ps3 jailbreak

    ReplyDelete
  34. I pay a quick visit day-to-day some websites and information sites to read posts,
    but this web site offers feature based writing.

    my blog; Psn Code Generator

    ReplyDelete
  35. It's a shame you don't have a donate button! I'd without a doubt donate to this superb blog! I guess for now i'll settle for
    bookmarking and adding your RSS feed to my Google account.
    I look forward to brand new updates and will talk about this site with my Facebook group.
    Chat soon!

    Feel free to surf to my homepage; Generateur De Code PSN

    ReplyDelete
  36. These are truly great ideas in concerning blogging. You
    have touched some fastidious points here. Any way keep up
    wrinting.

    Here is my web site :: The Interlace

    ReplyDelete
  37. Excellent article. Keep writing such kind of info on your site.
    Im really impressed by your site.
    Hi there, You have performed an excellent job. I
    will definitely digg it and personally suggest to my friends.

    I am confident they'll be benefited from this website.

    Check out my page - Psn Code Generator ()

    ReplyDelete
  38. Right here is the perfect blog for anyone who would like to
    understand this topic. You know a whole lot its almost tough to
    argue with you (not that I actually would want to…HaHa).
    You definitely put a brand new spin on a topic that
    has been written about for years. Wonderful stuff, just
    wonderful!

    My webpage - Download 7zip

    ReplyDelete
  39. What's up friends, pleasant piece of writing and pleasant arguments commented here, I am really enjoying by these.

    my site - World Of Tanks Hack

    ReplyDelete
  40. When someone writes an piece of writing he/she keeps the thought of a user in his/her mind that how a user can be aware of
    it. So that's why this post is great. Thanks!

    Here is my web page Minecraft Gift Code Generator

    ReplyDelete
  41. Nice post. I learn something new and challenging on websites
    I stumbleupon every day. It will always be exciting to read through articles from
    other authors and practice a little something from other
    web sites.

    Look at my site ... minecraft gift code generator

    ReplyDelete
  42. I simply could not leave your website before suggesting that I really loved the standard
    information an individual provide in your guests?
    Is going to be back frequently to check out new posts

    Check out my website :: Free Psn Codes

    ReplyDelete
  43. Today, I went to the beachfront with my children. I found a sea shell and gave it to my
    4 year old daughter and said "You can hear the ocean if you put this to your ear." She put the shell
    to her ear and screamed. There was a hermit crab inside and it pinched
    her ear. She never wants to go back! LoL I know this is totally off topic but I had to tell someone!


    Also visit my blog post; Minecraft Crack [www.Youtube.com]

    ReplyDelete
  44. ...I HAVENT EXAM A TESTIS OF ACROMEGALIC ARE THE TESTICLES ARE LARGE OR SMALL

    ReplyDelete