How Common is Acromegaly?

Illustration of acromegaly

Acromegaly is a rare, slowly progressive, chronic disorder that is caused by the hypersecretion of growth hormone in the body for adults. It is a similar disorder as gigantism but the difference is the onset of the disease. When the overproduction of growth hormone happens during childhood before the epiphyseal growth cartilage closes, the disease is called gigantism. This can cause an increase in the height of the patient. When the overproduction of growth hormones occur after the closing of the epiphyseal growth cartilage which usually happens in adulthood, the disease is called acromegaly. Although acromegaly does not cause an increase in the height anymore, it causes an enlargement of other body parts and tissues in adults.

The pituitary gland is the gland that produces the growth hormone and in acromegaly, it produces excessive levels of the growth hormone. In 90% of patients with acromegaly, the overproduction of the growth hormone is caused by a benign or noncancerous tumor found in the pituitary gland which is also known as an adenoma. The pituitary gland is a small gland that is located near the brain and is not only responsible for the production of growth hormone but is also responsible for the production of several important hormones that control body functions such as metabolism, growth and development, and reproduction. The growth hormone is responsible for regulating the physical growth of the body.
The tumor in the pituitary gland compresses the pituitary gland which results in an overproduction of the growth hormone that leads to acromegaly.

Scientists have estimated that there are about 3 to 4 out of every 1 million people in the world who develop acromegaly each year. 40 out of 60 out of every 1 million people suffer from this condition at any time. This condition can be treated in most patients but because of the slow progression of the signs and symptoms, the diagnosis is often delayed by 15 to 20 years. The hyperproduction of growth hormone usually starts between the 20s and 40s. The disease occurs in adults in between ages 30 to 50 years old, long after the epiphyseal growth plates have closed. The first signs of acromegaly are the coarsening of the facial features and the swelling of the hands and feet. The bones become deformed rather than elongated. The changes in the body occur slowly that’s why acromegaly is difficult to notice and is usually not recognized for years. It is usually recognized by reviewing serial photographs of the patient over the years to observe the physical changes in the patient.

The condition is not genetic or hereditary so it is therefore not passed on from a parent to a child through a genetic material. There are however some family tendencies or a set of conditions that can be passed on which makes a child most likely develop the condition. Acromegaly can only be inherited in rare cases and it is rather seen as part of other genetic conditions such as Carney Complex, multiple endocrine neoplasia types 1, McCune-Albright syndrome or in a condition known as ‘familial isolated pituitary adenoma’. The gene aryl hydrocarbon receptor interacting protein (AIP) when acromegaly begins in childhood or adolescence is regarded as an awareness factor.

There have been quite a few families that have inherited acromegaly and the inherited type of the disease is called familial isolated pituitary adenoma. If a member of the family has the gene for this disease, the other family members have a high risk of developing the adenoma in the pituitary gland and release excessive growth hormone while they are teenagers instead of when they are older. Since the changes occur while the bones can still grow, the excessive growth hormone lets the patients grow taller. This is a symptom of gigantism but the disease is actually more in an isolated case of acromegaly.

Acromegaly occurs in both men and women with equal frequency at it occurs at any age but is more frequent in the fourth or fifth decade. Aside from the early symptoms mentioned above, patients also experience the enlargement of some facial features especially the nose, the lower jaw, and the frontal bone. Because of the growth in the skull mass and soft tissue, the head size also increases. The ribs thicken and create barrel chests. The overgrowth of the cartilage and bone frequently results in osteoarthritis and as the condition progresses, the muscular weakness becomes more prominent and serious.
A patient with acromegaly may also experience visual disturbances and headaches that could eventually lead to blindness. Other body organs can also become enlarged such as the heart, kidneys, the liver, and the spleen. The more serious complications of acromegaly include hypertension, cardiomyopathy, and diabetes mellitus.

Given the fact that acromegaly is not hereditary and is a rare chronic disease, acromegaly is therefore not a common illness that can easily affect individuals. Acromegaly may be a rare disease but unlike other rare diseases, it can be treated once it is recognized in a patient. It is a rare disease that can be treated with surgery, radiation therapy, and drug therapy.