acromegaly - a disease characterized by abnormal growth of bones and soft tissues and disproportionate enforcement type.This disease occurs with the same frequency in both men and women aged 20 to 40 years.For acromegaly is characterized by a gradual and smooth development, and sufficiently long duration.
- 1 Causes of the disease
- 2 Symptoms
- 3 treatment of acromegaly
Causes of the disease
main reason for which may develop such diseases as acromegaly - is enhanced or increased production of the hormone growth hormone growth.But pathological conditions that stimulate the production of growth hormone, can be quite a lot.Among the most widespread and common etiological factors in the development of the disease are the following:
- available eosinophilic pituitary adenoma, actively producing growth hormone;
- hyperplasia specific acidophilic pituitary cells that actively produce growth hormone;
- focal malignant tumors localized in the frontal lobe of the brain;
- cyst formation in the cavity of a large tank - as a result of the recently moved infection or TBI (traumatic brain injury);
- somatotrofinoma - a hereditary disease;
- Sotos syndrome;
- -Rosenthal syndrome Klopfer;
- excessive secretion somatoliberin.
clinical picture of acromegaly often have a certain phasic flow.At a very early stage, which is called preakromegalicheskoy, symptoms of the disease is almost not expressed to diagnose acromegaly is why in the first stage is almost not given possible.The second stage of the course of the pathological process - hypertrophic - characterized by an increase of clinical signs.Tumor stage is characterized by symptoms of injury and dysfunction of adjacent structures (eg, increased intracranial pressure - intracranial pressure, which can lead to chronic intracranial hypertension, disorders of the organs of vision).The final stage of the initial course of the disease is cachectic, with which notes the depletion of the whole organism.
So, the basic "classic" symptoms of acromegaly manifestations are:
- frequent headaches, the cause of which is mainly intracranial hypertension;
- rapid fatigue, sleep disorder;
- progressive decline in vision: decreased visual acuity, reduced visual field.Fundus examination is marked edema, stasis, and subsequent atrophy of the optic nerve;
- at an early stage of disease progression can be observed an increase in muscle strength, which, however, subsequently replaced by its decline and atrophy of the muscles, until adinamii;
- pain in the lumbar spine and the joints;
- abnormal increase in the size of the upper and lower extremities.For their distal parts (hands and feet) typical shovel-view;
- upsize features: an increase of the nose, cheekbones, brow, ears and lips.Significantly increasing the size of the lower jaw, which extends anteriorly, the language is increasing to such an extent that hardly fit in the mouth.On the face appear larger coarse wrinkles;
- gradually coarsens his voice - as a result of thickening of the vocal ligament apparatus;
- as a result of increasing the size of the sebaceous and sweat glands observed increase in moisture and fat content of the skin, mainly in the field of natural skin folds and points of contact and friction of clothing.There has been increased growth of hair on the body and extremities;
- for later stages is characterized by the appearance of symptoms of multiple organ failure: pulmonary, cardiac, hepatic, renal failure;
- half of patients with acromegaly there is an increase in glucose tolerance;
- women complain of menstrual disorders, men - to reduce the sexual function;
- if the observed increase in tumor mass in the direction of the hypothalamus, the patients complained of thirst, increased drowsiness, polyuria, fluctuations in body temperature;
- during radiographic examinations revealed destructive changes sella, giprostoz cranial vault, pnevmotizatsiya main and the temporal bone of the skull.
treatment of acromegaly
main goal of treatment for acromegaly is to reduce the concentration of growth hormone in the blood.In this connection, three main lines in the treatment of this disease:
- pharmacological treatment : mainly used tools such as: dopamine agonists, antagonists somatotropic receptors, somatostatin analogs;
- surgery : directed at the eradication of the causes of the disease - the removal of the pituitary tumor.Surgery can be performed in two ways: Transsphenoidal and endonasal transsphenoidal.In the first case, the incision is made in the maxillary gingiva, partitions up to the nasal cavity, then the tumor is removed.In the second case, the entrance to the nasal cavity directly through the nostrils using microtoolkit.However, it is worth remembering that even after surgical removal of the pituitary tumor is necessary to strengthen the result of using medical pharmacotherapy;
- radiation therapy: This technique can be used independently as a basic method of treatment, but mostly it is used in combination therapy with drugs or additional postoperative treatment.In radiation therapy, it decided to allocate two basic modes: the first - the appointment procedure for 1.5 months to 5 times during the week, and the second - is known as Stereotactic radiosurgery and represents a meaningful impact on the tumor by intense beams of light.