Growth Hormone Excess - Pathogenesis and clinical findings

 • Acromegaly and gigantism share the same pathophysiology but differ mainly in terms of time of onset of GH excess. GH excess prior to growth plate fusion -> gigantism. GH excess after growth plate fusion -> acromegaly.

 • Other rare causes of acromegaly include GHRH hypothalamic tumors and ectopic secretion of GHRH by neuroendocrine tumors.

Increased intracranial Pressure:

 • Headache

 • Decr visual confrontation

 • Decr visual acuity

 • Bitemporal hemianopsia

IGF-1 Overproduction -> Connective tissue overgrowth:

 • Carpal Tunnel Syndrome

 • Acne

 • Coarse features

 • Hyperhydriosis

 • Hypertrichiosis

 • Macrognathia 

 • Enlarged hands and feet

Excess Insulin Secretion:

 • Acanthosis Nigricans

 • Impaired glucose tolerance

 • Weight gain

Cardiovascular disease:

 • Cardiac arrhythmia

 • Valvular damage

 • decr eiection fraction

 • HTN



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