Acromegaly

Big picture

Acromegaly is a chronic disease caused by excess growth hormone (GH), usually from a GH-secreting pituitary adenoma, leading to increased insulin-like growth factor 1 (IGF-1). The key clinical idea is:

GH excess after epiphyseal plate closure → acral and soft tissue enlargement = acromegaly GH excess before epiphyseal plate closure → linear overgrowth = gigantism

The disease is often diagnosed late because changes are slow: larger shoe/ring size, coarser facial features, sweating, snoring, hypertension, diabetes mellitus, arthropathy, and carpal tunnel syndrome. The examiner wants you to recognize the phenotype, confirm it correctly, and know that random GH alone is not enough because GH secretion is pulsatile. Diagnosis relies on IGF-1 screening and failure of GH suppression during oral glucose tolerance test (OGTT). ([PMC][1])

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