Acromegaly
Overview
Acromegaly is a condition caused by a benign tumor on the pituitary gland that results in the body's excessive production of growth hormone. Growth hormone is essential during puberty and is responsible for growth spurts. But after puberty, growth hormone production ordinarily drops to very low levels.
The condition causes abnormal growth in adults and what's called "gigantism" in children, who have not yet reached puberty, causing them to grow abnormally large.
Our approach to acromegaly
UCSF offers highly specialized, world-class care for pituitary disorders, such as acromegaly. Our team includes experts in neuroendocrinology, neurosurgery and radiation therapy, among other specialties.
The primary treatment for acromegaly is to remove the noncancerous pituitary tumor that is producing the excess growth hormone. UCSF surgeons developed and refined many of the standard surgical techniques for removing pituitary tumors, and we use a technique pioneered here, called the transsphenoidal approach, in which neurosurgeons guide instruments through the nose to reach the pituitary gland. This approach is safer than traditional surgery and leaves no scars. UCSF has more experience with this procedure than any other program in the nation and has a record of excellent outcomes.
If the tumor can't be removed completely because it has grown into surrounding tissues, radiation therapy or medication can normalize growth hormone levels for many patients.
Awards & recognition
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Among the top hospitals in the nation
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Best in the West and No. 3 in the nation for neurology & neurosurgery
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Best in Northern California for diabetes care & endocrinology
Signs & symptoms
In acromegaly, elevated growth hormone causes an abnormal increase in shoe and ring size, enlargement of the lower jaw bone and separation of teeth, and enlargement of the nose. These developments usually occur gradually and may not be noticed for years.
Other tissue in the body also can become enlarged, causing symptoms such as:
- Carpal tunnel syndrome
- Deepening of the voice
- Diabetes
- Excessive sweating and changes in body odor
- Increased risk of colon polyps
- Joint pain and stiffness
- Sleep apnea and snoring due to obstruction of the airway
- Thickening of the heart muscles
Diagnosis
To diagnose acromegaly, a doctor measures the growth hormone level in the blood to determine if it's elevated. Because the level of growth hormone can vary widely throughout the day, the level must be measured over an extended period of time.
Doctors also may measure what's called insulin-like growth factor 1 (IGF-1), which the body produces in an attempt to suppress the growth hormone.
After acromegaly has been diagnosed by blood tests, a magnetic resonance imaging (MRI) or computed tomography (CT) scan of the pituitary is used to locate the tumor causing the overproduction of growth hormone.
Treatments
The principal treatment for acromegaly is transsphenoidal surgery to remove the pituitary tumor. Because the condition can develop very slowly, tumors are often large and can invade surrounding tissue by the time symptoms emerge. If the tumor has spread beyond the pituitary gland, radiation therapy or medication may be part of the treatment.
Medication is prescribed to normalize growth hormone levels. The drug octreotide inhibits growth hormone release. Long-term treatment can result in normal levels of growth hormone and IGF-1 in more than half of patients with the condition. A newer drug, called pegvisomant, binds to growth hormone receptors and can normalize IGF-1 levels in 90 percent of patients. A class of drugs called dopamine agonists has also been used, although they normalize growth hormone levels in just 15 to 30 percent of patients.
UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.
