Acromegaly is a rare disease which is caused when the pituitary gland produces too much growth hormone.Normally a benign (non cancerous) tumor of the pituitary gland results in the gland producing too much growth hormone.Too much growth hormone in children produces gigantism rather than acromegaly.Symptoms of acromegaly are:1. Reduced muscle strength (weakness)2. Reduced peripheral vision3. Easy fatigue4. Increased height5. Large bones of the face6. Large feet (change in shoe size), large hands (change in ring or glove size)7. Large glands in the skin (sebaceous glands)8. Large jaw (prognathism) and tongue (macroglossia)There are other symptoms that may occur with this condition:1. Colon polyps2. Increased hair growth in females (hirsutism)3. Type 2 diabetes4. Enlarged thyroidTo confirm diagnosis of acromegaly the following tests may be done:1. Growth hormone2. Blood glucose3. High insulin-like growth factor 1 (IGF-1) level4. Spine x-ray5. MRI of the brain, including the pituitary glandTreatment1. Surgery for removal of the pituitary tumor that is causing this condition often treats the release of abnormal growth hormone.Sometimes the tumor is too big to remove totally.2. People who are not responsive to surgery may have radiation of the pituitary gland.3. Tests of pegvisomant (Somavert), a GH-receptor antagonist, showed effective suppression of GH and IGF-I levels in patients with acromegaly due to pituitary tumors or ectopic GHRH hypersecretion.Normalization of IGF-I levels occurs in as many as 90% of patients treated daily with this drug for 3 months.4. Bromocriptine (Parlodel, Cycloset)This is the dopamine-receptor agonist that is most often used to treat GH and prolactin excess.It is safe when administered to a child for extended period.In acromegaly, a severe disease that is often diagnosed late, morbidity and mortality rates are high, particularly as a result of associated cardiovascular, cerebrovascular, and respiratory disorders and malignancies.Because IGF-I is a general growth factor, somatic hypertrophy in acromegaly occurs across all organ systems.Associated complications include the following:1. Acromegalic heart2. Increased muscle and soft tissue mass3. Increased kidney size4. Articular overgrowth of synovial tissue and hypertrophic arthropathy5. Joint symptoms, back pain, and kyphosisTABLE OF CONTENTIntroductionChapter 1 AcromegalyChapter 2 CausesChapter 3 SymptomsChapter 4 DiagnosisChapter 5 TreatmentChapter 6 PrognosisChapter 7 Dwarfism or Growth Hormone DeficiencyEpilogue