Did you know that 'giantism' has different symptoms between adults and children? Causes and treatment

 

Giganticism is a disease that both adults and children can develop, and many people are concerned about its characteristic appearance. Also, did you know that gigantism can cause various symptoms related to the pituitary gland and various hormones? This time, we will look at the characteristics and symptoms of such giantism. Let's learn more about the differences in symptoms between adults and children and how to treat them.

What is giant authentication?

Giganism is a disease in which various symptoms appear due to excessive secretion of growth hormone. As you can imagine from the name 'Giantness', the body grows. In addition, it is characterized by a risk of developing diseases such as diabetes, high blood pressure and heart failure. The incidence of gigantism, including acromegaly, is known to be 4 to 5 per million people. It is one of the designated incurable diseases designated by the disease name 'hypersecretion of pituitary growth hormone', and is a rare disease with a prevalence of 50 to 60 per million people.

I heard there are different types of giant certificates...

There are two types of gigantism, 'pituitary gigantism' and 'apical megalomania'. Also, if the onset occurs after becoming an adult, it is called acromegaly. Even if it is 'giantism' in one word, it is characterized by different symptoms depending on adults and children.

okay. What's the difference between adult and child giants?

The main difference between adult and child gigantism is how symptoms appear. All are characterized by the appearance of various symptoms due to excessive secretion of growth hormone. However, children who are in the skeletal stage of growth and adults who have stopped growing do not show symptoms in the same way. There is a tissue called epiphyseal cartilage tendon in the bone, and under the influence of growth hormone, it elongates and grows taller. However, since the epiphyseal cartilage is closed after the growth phase, adults are not tall and the tip of the body is enlarged.

Please let us know if there are any symptoms that appear when gigantism occurs.

When gigantism develops, children are characterized by growing to abnormal heights. It's not just the image of 'the tallest kid in the class'. It is characterized by being too large compared to children of the same age, so the disease name 'giantism' is attached. Also, when gigantism develops, secondary sexual characteristics are often delayed. In the case of acromegaly, which develops after becoming an adult, the tip of the body such as the jaw, nose, earlobe, limbs, and tongue increases, not the height.

In some cases, it is easy to sweat a lot or the chest plate becomes thick.

However, changes in appearance don't happen rapidly, and it can take several years from the onset to realizing it. In acromegaly, in addition to changes in appearance, menstrual irregularities, infertility, and lactation in women, and erectile dysfunction in men are often symptoms.

Is there something that causes gigantism?

The symptoms of gigantism are caused by excessive secretion of growth hormone, but most of the causes are benign tumors called pituitary adenomas. In the brain, there is an organ called hypotrichosis, which secretes growth hormone, as well as various hormones related to mammary gland development, sugar and lipid metabolism, and sperm and egg production. The pituitary gland is a small organ the size of a bean, and it plays a very important role.

How is gigantism diagnosed?

Giganticism is one of the endocrine disorders caused by excessive secretion of growth hormone. Therefore, the treatment of gigantism is specialized in endocrinology. Also, since the pituitary gland is located in the brain, it can be diagnosed in neurosurgery. But 'what if... ' Even if you think about it, there may be people who have high barriers to suddenly seeing an endocrinologist or neurosurgeon. If you suspect your child's gigantism, first consult your pediatrician. In the case of an adult, please see your doctor or internal medicine doctor. If there are findings suspicious of gigantism, a letter of introduction is written to a large hospital equipped with testing equipment and treatment systems.

I would like to know the contents of the tests performed when diagnosing gigantism.

If you have symptoms that suggest gigantism, blood tests, X-ray tests, CT scans, MRI tests, etc. are performed to link the diagnosis. Because the characteristic symptoms of gigantism and acromegaly occur due to excessive secretion of growth hormone, the level of growth hormone is checked in a blood test. If the growth hormone level is higher than the normal value, of course, excessive secretion should be suspected. However, since it cannot be judged with a single value, it is judged that there is excessive secretion if the value is the same high by testing it several times. In addition, checking the growth hormone level movement through a glucose tolerance test taking glucose is also useful for diagnosis. Also, since most of the causes of gigantism are pituitary adenomas, blood tests and head MRI scans are mainly performed from general contents to endocrine hormones to confirm pituitary adenomas. The blood test confirms an increase in the blood concentration of growth hormone and its downstream hormone called 'IGF-1', which promotes secretion.

In addition, a load test is performed to check the change in the blood concentration of growth hormone by orally ingesting a certain amount of sugar.

Normally, growth hormone in the blood decreases with sugar load, but it is confirmed that it rises conversely when this gigantism (pituitary adenoma) is present. A CT scan or MRI scan of the head is done to check for a pituitary adenoma. In addition, X-rays of the carpal bones are mainly taken, and in children, the difference between the actual age and the age of the bones is evaluated. Since most of the causative diseases of gigantism are due to pituitary adenoma, treatment similar to that of pituitary adenoma can be taken. Surgery is the first choice for treatment, but depending on the situation, drug therapy or gamma knife may be used instead.

Please tell us about the dangers of neglecting the giant certificate.

Giganticism is not just a disease of becoming too tall or the tip of the body. If left untreated, it increases the risk of developing diseases such as diabetes, high blood pressure, heart failure, colorectal cancer and thyroid cancer. Diabetes and hypertension are many complications, and control is required along with the treatment of gigantism. In some cases, the heart enlarges due to excessive secretion of growth hormone, and the risk of heart failure is increased because the heart is always under load. In addition, there are many cases in which a thyroid adenoma presses on the head, causing headaches, narrowed vision, numbness in the hands and feet, and malaise.

An enlarged tongue also increases the risk of sleep apnea. Neglecting gigantism like this can cause life-related symptoms. Therefore, it is known that when gigantism develops, the mortality rate from the disease is higher than that of peers.

What is the treatment for gigantism?

Gigantosis may be cured by removing the cause of the pituitary adenoma. In some cases, pituitary adenomas are large and cannot be completely removed, but if growth hormone can be controlled with drugs, symptoms can be suppressed. If you have diabetes or high blood pressure, such follow-up should also be followed. It is also important to get proper treatment to avoid causing life-related complications.

I would like to know how to cure gigantism.

Most of the treatment methods for gigantism are based on surgery for a pituitary adenoma. There are two methods: removing it from the nasal cavity (nostril) through an endoscope, and placing a knife on the head called an opening. If the tumor is small enough to pass through the nostrils, it can be resected through an endoscope, but if the tumor is large, it is a craniotomy. Since all surgeries are performed under general anesthesia, there are many people who feel anxious both in terms of 'head surgery' and 'general anesthesia'.

It is important to check the anxiety in advance and proceed with surgery after resolving it.

Radiation therapy is sometimes done if the pituitary adenoma cannot be removed by surgery. In addition, it can be expected that tumors will become smaller by reducing the amount of growth hormone by administering a somatostatin analog as a medical drug treatment. Others use dopamine agonists. In any case, the treatment of gigantism does not end in a short time. It can be said that support from those around you is indispensable.

Is gigantism a relapse, etc.? I'm worried...

Even after surgery, the chance of recurrence is not zero. If the pituitary adenoma is not largely removed or if the pituitary adenoma has infiltrated the surrounding tissue, it does not heal and there is a risk of recurrence. However, it is possible to reduce pituitary adenomas or control hormones with radiation therapy or drug therapy. If left uncontrolled, it can become a life-threatening condition with an increased risk of recurrence or exacerbation. Therefore, it is important not to stop treatment or regular care.

When gigantism develops, children are characterized by unusually taller than their peers. In the case of an adult, the extremity of the body grows rather than the height, and there are many people who feel it as a complex from its characteristic appearance. Since there are many cases of serious symptoms in the body, early detection and early treatment are important. It is recommended that you consult your doctor if you have any symptoms that concern you, as there is a risk of developing life-related diseases if left untreated.

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Giant disease is a benign tumor called a pituitary adenoma, which is caused by excessive secretion of growth hormone. Diabetes and high blood pressure, as well as external symptoms such as high height or hypertrophy of the extremities, should be taken care of. Early detection and early treatment are important because if gigantism or acromegaly is left untreated, it puts a load on the heart or increases the risk of thyroid cancer and colorectal cancer. The disease can be controlled by surgically removing the pituitary adenoma or by combining radiation therapy and drug therapy. 'Isn't the child too tall?' If you have any symptoms of concern, such as 'the chin or nose seems to be enlarged', please seek medical attention as soon as possible and lead to early detection and early treatment.