Acromegaly
| Incidental findings | Scar from transfrontal resection |
| +ve signs | Large hands, protrusion lower jaw, inderdental separation, macroglossia |
| Differential diagnosis | Acromegaly |
| Function | Comment on disease activity: Sweating, hypertension, glycosuria, headache |
| Tests |
ECG, CXR – cardiomegaly Oral GTT – failure of supression / paradoxical increase growth hormone IGF-1 level MR pituitary fossa T4, prolactin, testosterone. Triple stimulation if ?hypopit Formal perimetry |
Extensions
- Look for macroglossia
- Visual fields
- Tinel’s test
- Fundoscopy (hypertension, diabetes)
- Questions: Size of hat, shoes; change in appearance; hypertension
Notes
- Most patients treated with surgery, usually trans-spenoidal. Radiation if not surgical candidate. Can also use somatostatin analogues (octreotide) or bromocriptine.
- Causes of death: cardiac failure, hypertension complicatins, tumour expansion / haemorrhage