1 min read - Acromegaly



This 54 years old patient is under medical clinic follow up for hypertension and diabetes mellitus. Both his blood pressure and blood sugar control are suboptimal.

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What are the clinical features shown here?

  • Coarse facial features
  • Prominent supraorbital ridges
  • Enlarged lips/ nose - But to confirm has to be compared with old photographs
  • Prognathism
  • Enlarged hands and feet


What is the diagnosis?

  • Acromegaly
How do you confirm the diagnosis?

  • IGF1 level
  • Oral glucose tolerance test with GH level.
    • GH will not be suppressed. It can even rise.


What are the treatment options?

  • The commonest cause is GH secreting pituitary macroadenoma
    • It can be resected through trans-sphenoidal approach or open craniotomy.
  • Medical management (If unresectable or persistent disease after resection)
    • Somatostatin analogues (Octreotide)
    • Dopamine agonists (Cabergoline)
    • GH receptor antagonists (Pegvisomant)

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