Acromegaly Gigantism

• Facts:
  Adult condition from excess GH, from benign pituitary GH adenoma
• History / PE:
  Enlargement of jaw, hands, feet
  Coarse facial features
  Carpal tunnel syndrome and arthritis
  Diastolic dysfunction , uncontrolled HTN
  Bitemporal hemianopsia
• Diagnosis:
  Measure GH after oral glucose load (GH levels remain high)
  Increase in Insulin-like growth factor 1 (IGF-1)
  
• Complications:
  Cardiovascular failure
  
• Notes:
  Children w/ excess GH present with gigantism
  Excess GH may lead to glucose intolerance/DM
• Associated With:
  Colonic polyps /carcinoma (close screening with colonoscopy is indicated)
• Differential Diagnosis:
  Paget's disease