Acromegaly
Defination
Pathophysiology
Risk factor
Causes
Acromegaly is a rare disorder of excessive bone and soft tissue growth due to elevated levels of growth hormone.
Some rare cases of acromegaly are hereditary.
The average age of diagnosis is 40-45 years old.
In most cases, acromegaly is caused by over-secretion of growth hormone (GH) produced by a benign tumor of the pituitary gland
The pituitary gland is a small gland located at the base of the brain that produces many hormones.
In a small number of cases, malignant tumors of other organs (pancreas, adrenal, lung) may be the source of excess GH.
Medical management
Surgical management
Signs and symptoms
Skin changes, such as:
Thickened, oily, and sometimes darkened skin
Abnormally large growth and deformity of the:
Hands (rings nlonger fit)
Deepening voice due tenlarged sinuses, vocal cords, and soft tissues of the throat
Fatigue and weakness in legs and arms
Enlargement of the liver, kidneys, spleen, heart, and/or other internal organs, which can lead to:
Diabetes
Arthritis and other joint problems especially in the jaw and
Hypothyroidism
In women:
Irregular menstrual cycles
Treatment
Reduce production of GH to normal levels
Stop and reverse the symptoms caused by over-secretion of GHmple.com)
Correct other endocrine abnormalities (thyroid, adrenal, sex organs)
Reduce the tumor size
Sugery
Radiography
Radiosurgery is the use of highly focused external beams of radiation tshrink the tumor.
It is used most often in patients whdnot respond tconventional surgery or medications.
Surgical removal of the pituitary tumor, or other tumor, that is believed to be causing acromegaly may be done.
In most cases, this is the preferred treatment.
Radiosugery
Radiosurgery is the use of highly focused external beams of radiation tshrink the tumor
It is used most often in patients whdnot respond tconventional surgery or medications.
Radiation Therapy
Radiation therapy is used in combination with either medical and/or surgical treatment.
Cabergoline (Dostinex)—given orally
Pergolide (Permax)—given orally
Bromocriptine (Parlodel)—may be given before surgery tshrink tumor
Octreotide (Sandostatin)—given by injections
Pegvisomant—given by injections for patients not responding tother forms of treatment
Nursing Diagnoses
Disturbed Body Image related to anxiety over thickened skin and enlargement of face, hands, and feet.
Ineffective Coping related to change in appearance.
Disturbed Sensory Perception
Disturbed Sleeping Pattern related to soft tissue swelling
Fluid Volume Deficit
Anxiety related to change in appearance
Assessment and common findings
Change in facial features with nose enlargement,
lip thickening bulging of the forehead and enlargement of the hands and feet.
Shoes do not fit.
Change in facial features with nose enlargement,
excess growth hormone release by the pituitary gland and secondary release of insulin-like growth factor 1 (IGF-1) results in exaggerated skeletal and organ growth occurring after epiphyseal closure