Large hands and feet can be a symptom of a serious illness

How often do medical practitioners, when examining a patient, pay attention to his hands and feet, estimating their size? Surely, quite rarely, because, it would seem, what useful information can such an inspection provide? However, it is the increase in the size of the palms, feet and some other parts of the body that is the main symptom of the development of a hormone-producing pituitary adenoma, which causes acromegaly disease.

There are 3-4 cases of acromegaly per 1 million population annually. The probability that such a patient can come to an appointment with a doctor of any specialty is quite high. Therefore, practicing doctors need to have enough information about what symptoms acromegaly can manifest.

Why can a pituitary adenoma cause acromegaly?

Acromegaly – this is a disease of the endocrine system, in which there is a chronic overproduction of growth hormone by the pituitary gland – STG. If such a pathology occurs at a young age – pituitary gigantism develops – accelerated growth of skeletal bones and soft tissues. At the same time, male patients can reach a height of more than 200 cm, and female – over 190 cm.

If hyperproduction of growth hormone occurs at an older age – acromegaly develops, in which bones, soft tissues and internal organs grow disproportionately, which means that the pathology provoked by the development of pituitary adenoma affects all body systems.

Clinical presentation of acromegaly: main symptoms

In the clinical picture of acromegaly, an increase in the size of the hands and feet comes to the fore. There is an enlargement of facial features: the lower jaw, superciliary arches and cheekbones. Soft tissues also grow – ears, tongue and nose, fingers thicken, they have a characteristic cigar-shaped appearance. The size of the internal organs is also increasing – splanchnomegaly, which leads to the development of their pathology: liver cirrhosis, pneumosclerosis, cardiomyopathy, pancreatic fibrosis.

The proliferation of muscle tissues results in myopathy – muscles lose their contractility. Pulmonary heart failure can eventually lead to the death of the patient, which is why acromegaly is so important to identify and treat in time.

There are several degrees of severity of acromegaly:

• with mild acromegaly, the patient copes well with normal physical activity and does not require hospitalization;
• with moderate severity, the patient is unable to perform physical activity and feels tired for almost half of the active time of the day;
• with severe acromegaly, the patient cannot take care of himself and almost completely observes bed rest.

Laboratory and instrumental methods for diagnosing acromegaly

Diagnosis of acromegaly is based primarily on laboratory tests. It is necessary to investigate the level of growth hormone, for this a special test with glucose is performed. After taking glucose, the level of growth hormone is measured after half an hour, an hour, one and a half and two hours. Normally, the level of growth hormone after taking glucose should decrease, with acromegaly, on the contrary, its increase is noted.

An important laboratory criterion for acromegaly is the study of insulin-like growth factor, which is also elevated in this disease. Instrumental diagnostic methods, such as X-ray, computed tomography and magnetic resonance imaging, provide information about the expansion of the Turkish saddle, which indicates the development of pituitary adenoma.

Conservative and surgical treatments for acromegaly

Treatment of acromegaly can be conservative or surgical. Conservative treatment is aimed primarily at eliminating the symptoms of the disease. For this purpose, patients with acromegaly are prescribed hormonal drugs that suppress excessive production of growth hormone. If there are contraindications to taking hormonal drugs – Radiation therapy is recommended for patients.

But it is possible to completely eliminate the disease only through surgical intervention. Patients with acromegaly undergo endoscopic transnasal-transsphenoidal removal of the pituitary adenoma. After surgery, a complete remission of the disease is observed in almost 70% of patients.