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. 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)