4
GH Excess: Pathogenesis and Clinical Findings
4, joint spaces
Macroadenoma (>1cm)
Somatotroph adenoma in anterior pituitary
Microduplications in chromosome Xq26.3
4— Plain film
CT/M RI
GH secretion 1\ frequency and amplitude
► GH excess

Imaging 4— Acromegaly/Gigantism
Stimulation/ repression of other hormones
Authors: David Deng Reviewers: Amyna Fidai Hamna Tariq Joseph Tropiano Karin Winston * MD at time of publication

intracranial Pressure
Headache 4—
4, visual confrontation
4, visual acuity
Bitemporal hemianopsia
Abbreviations: • GH: Growth hormone • GHRH: Growth hormone releasing hormone • FSH: Follicle stimulating hormone • LH: Luteinizing hormone • TSH: Thyroid stimulating hormone
Legend:
4–
Local IGF-1 overproduction
Median nerve edema
Connective tissue Carpal tunnel overgrowth syndrome
Acne 4
Coarse features
Hyperhydriosis
Pathophysiology Mechanism
Hypertrichiosis
Macrognathia 1—
Enlarged hands and feet
Sign/Symptom/Lab Finding

Excess insulin secretion
\I, insulin receptor numbers and affinity

Acanthosis Nigricans
Impaired glucose tolerance
Cardiovascular disease
Weight gain
Cardiac arrhythmia
Valvular damage
ejection fraction
► HTN
Notes: • 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 4 gigantism. GH excess after growth plate fusion 4 acromegaly. • Other rare causes of acromegaly include GHRH hypothalamic tumors and ectopic secretion of GHRH by neuroendocrine tumors.
Complications
Published January 28, 2018 on www.thecalgaryguide.com