Gigantism Health Dictionary

Gigantism: From 3 Different Sources


Excessive growth (especially in height), resulting from overproduction of growth hormone during childhood or adolescence by a tumour of the pituitary gland (see pituitary tumours). Untreated, the tumour may compress other hormone-producing cells in the pituitary gland, causing symptoms of hormone deficiency (see hypopituitarism). The condition may be treated with drugs such as bromocriptine that block the release of growth hormone, or by surgery or radiotherapy to remove or destroy the tumour. See also acromegaly.
Health Source: BMA Medical Dictionary
Author: The British Medical Association
Excessive growth (mainly in height) caused by overproduction, during childhood or adolescence, of GROWTH HORMONE by a tumour of the PITUITARY GLAND. Untreated, the affected individual may die in early adulthood. Sometimes the tumour appears after the individual has stopped growing and the result then is ACROMEGALY rather than gigantism.
Health Source: Medical Dictionary
Author: Health Dictionary
n. abnormal growth causing excessive height, most commonly due to oversecretion during childhood of *growth hormone (somatotrophin) by the pituitary gland. In eunuchoid gigantism the tall stature is due to delayed puberty, which results in continued growth of the long bones before their growing ends (epiphyses) fuse. See also Sotos syndrome.
Health Source: Oxford | Concise Colour Medical Dictionary
Author: Jonathan Law, Elizabeth Martin

Growth Hormone

A product of the anterior part of the PITUITARY GLAND that promotes normal growth and development in the body by changing the chemical activity in the cells. The hormone activates protein production in the muscle cells as well as the release of energy from the metabolism of fats. Its release is controlled by the contrasting actions of growth-hormone releasing factor and somatostatin. If the body produces too much growth hormone before puberty GIGANTISM results; in adulthood the result is ACROMEGALY. Lack of growth hormone in children retards growth.

For many years growth hormone was extracted from human corpses and very rarely this caused CREUTZFELDT-JAKOB DISEASE (CJD) in the recipients. The hormone is now genetically engineered, so safe.... growth hormone

Acromegaly

A disorder caused by the increased secretion of growth hormone by an ADENOMA of the anterior PITUITARY GLAND. It results in excessive growth of both the skeletal and the soft tissues. If it occurs in adolescence before the bony epiphyses have fused, the result is gigantism; if it occurs in adult life the skeletal overgrowth is con?ned to the hands, feet, cranial sinuses and jaw. Most of the features are due to overgrowth of the cartilage of the nose and ear and of the soft tissues which increase the thickness of the skin and lips. Viscera such as the thyroid and liver are also affected. The overgrowth of the soft tissues is gradual.

The local effects of the tumour commonly cause headache and, less frequently, impairment of vision, particularly of the temporal ?eld of vision, as a result of pressure on the nerves to the eye. The tumour may damage the other pituitary cells giving rise to gonadal, thyroid or adrenocortical insu?ciency. The disease often becomes obvious in persons over about 45 years of age; they may also complain of excessive sweating, joint pains and lethargy. The diagnosis is con?rmed by measuring the level of growth hormone in the serum and by an X-ray of the skull which usually shows enlargement of the pituitary fossa.

Treatment The most e?ective treatment is surgically to remove the pituitary adenoma. This can usually be done through the nose and the sphenoid sinus, but large adenomas may need a full CRANIOTOMY. Surgery cures about 80 per cent of patients with a microadenoma and 40 per cent of those with a large lesion; the rate of recurrence is 5–10 per cent. For recurrences, or for patients un?t for surgery or who refuse it, a combination of irradiation and drugs may be helpful. Deep X-ray therapy to the pituitary fossa is less e?ective than surgery but may also be helpful, and recently more sophisticated X-ray techniques, such as gamma knife irradiation, have shown promise. Drugs – such as BROMOCRIPTINE, capergoline and quiangoline, which are dopamine agonists – lower growth-hormone levels in acromegaly and are particularly useful as an adjunct to radiotherapy. Drugs which inhibit growth-hormone release by competing for its receptors, octeotride and lanreotride, also have a place in treatment.

See www.niddk.nih.gov/health/endo/pubs/ acro/acro.htm

www.umm.edu/endocrin/acromegaly.htm... acromegaly

Hyperpituitarism

Overactivity of the anterior lobe of the PITUITARY GLAND, causing ACROMEGALY (GIGANTISM).... hyperpituitarism

Pituitary-linked Disorders

ACROMEGALY or gigantism is the result of the overactivity of, or tumour formation of cells in, the adenohypophysis which produces GROWTH HORMONE (see also PITUITARY GLAND). If this overactivity occurs after growth has ceased, acromegaly arises, in which there is gross overgrowth of the ears, nose, jaws, and hands and feet. DWARFISM may be due to lack of growth hormone.

DIABETES INSIPIDUS, a condition characterised by the passing of a large volume of URINE every day, is due to lack of the antidiuretic hormone (see VASOPRESSIN). Enhanced production of the ADRENOCORTICOTROPHIC HORMONE (ACTH) leads to CUSHING’S SYNDROME. Excessive production of PROLACTIN by micro or macro adenomas (benign tumours) leads to hyperprolactinaemia and consequent AMENORRHOEA and GALACTORRHOEA. Some adenomas do not produce any hormone but cause effects by damaging the pituitary cells and inhibiting their hormone production.

The most sensitive cells to extrinsic pressure are the gonadotrophin-producing cells and the growth-hormone producing cells, so that if the tumour occurs in childhood, growth hormone will be suppressed and growth will slow. Gonadotrophin hormone suppression will prevent the development of puberty and, if the tumour occurs after puberty, will result in amenorrhoea in the female and lack of LIBIDO in both sexes. The thyroid-stimulating hormone cells are the next to suffer and the pressure effects on these cells will result in hypothyroidism (see under THYROID GLAND, DISEASES OF).

Fortunately the ACTH-producing cells are the most resistant to extrinsic pressure and this is teleologically sound as ACTH is the one pituitary hormone that is essential to life. However, these cells can suffer damage from intracellular tumours, and adrenocortical insu?ciency is not uncommon.

Information about these disorders may be obtained from the Pituitary Foundation.... pituitary-linked disorders

Giddiness

See: VERTIGO.

GIGANTISM. Abnormal height resulting from excessive growth hormone secretion by the pituitary gland in the adolescent. See: PITUITARY GLAND. ... giddiness

Macrognathia

n. a condition in which one or both jaws are abnormally large. It can be associated with pituitary *gigantism, tumours, and other disorders. It can often be corrected with surgery.... macrognathia

Sotos Syndrome

(cerebral gigantism) a rare inherited disorder resulting in excessive physical growth during the first 2–3 years of life. It presents in childhood with a characteristic facial appearance, a disproportionately large head, large hands and feet, abnormally widely spaced eyes (ocular *hypertelorism), developmental delay, and tall stature for age. Children with Sotos syndrome tend to be large at birth and taller and heavier, stabilizing after about five years to achieve normal adult height. Most cases occur sporadically, although familial cases have been reported. [J. F. Sotos (1927– ), U.S. paediatrician]... sotos syndrome

Growth, Childhood

The increase in height and weight as a child develops. The period of most rapid growth occurs before birth. After birth, although growth is still rapid in the first few years of life, especially in the first year, the rate of

growth steadily decreases. Puberty marks another major period of growth, which continues until adult height and weight are reached, usually at about age 16–17 in girls and 19–21 in boys.

Body shape changes during childhood because different areas grow at different rates. For example, at birth, the head is already about three quarters of its adult size; it grows to almost full size during the first year. Thereafter, it becomes proportionately smaller because the body grows at a much faster rate.

Growth can be influenced by heredity and by environmental factors such as nutrition and general health. Hormones also play an important role, particularly growth hormone, thyroid hormones, and, at puberty, the sex hormones.

A chronic illness, such as cystic fibrosis, may retard growth. Even a minor illness can slow growth briefly, although the growth rate usually catches up when the child recovers. In some cases, slow growth may be the only sign that a child is ill or malnourished, in which case it is known as failure to thrive. However, short stature does not necessarily indicate poor health. Abnormally rapid growth is rare. Usually, it is a familial trait, but it may occasionally indicate an underlying disorder, such as a pituitary gland tumour causing gigantism. (See also age; child development.)... growth, childhood

Pituitary Tumours

Growths in the pituitary gland. Pituitary tumours are rare, and mostly noncancerous, but tumour enlargement can put pressure on the optic nerves, causing visual defects.

The causes of pituitary tumours are unknown. They may lead to inadequate hormone production, causing problems such as cessation of menstrual periods or reduced sperm production. They may also cause the gland to produce excess hormone. Overproduction of growth hormone causes gigantism or acromegaly; too much thyroid-stimulating hormone (TSH) can lead to hyperthyroidism. Investigations include blood tests, X-rays, MRI of the pituitary, and usually also vision tests. Treatment may be by surgical removal of the tumour, radiotherapy, hormone replacement, or a combination of these techniques. The drug bromocriptine may be used; it can reduce production of certain hormones and shrink some tumours.... pituitary tumours




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