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Acromegaly Pathology

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Description of Pathology

Acromegaly is a rare disease that results from an overgrowth of hormones manufactured by the anterior pituitary gland (Adigun et al., 2023). The pituitary gland is in the brain and produces growth hormones (GH). In Acromegaly, excess growth hormones are produced, causing body tissues to grow excessively and other metabolic systems in the body to become dysfunctional. The primary cause of this disease is a benign tumor, specifically the adenoma found in the pituitary gland. The tumor causes the pituitary gland to produce and release a lot of GH into the blood causing metabolic changes. This triggers the production of insulin-like growth factor 1 (IGF-1), which leads to overgrowth (Adigun et al., 2023). In children who still have open growth plates, this results in gigantism, while in adults, the effects are seen in their organs, tissues, and bones. The physical symptoms of Acromegaly in adults are a big forehead, large feet, and hands, and a large jawline.

Acromegaly statistics show that it affects approximately 4,600 in every 1 million population. Annually, there is a case of around 116.9 people being diagnosed with the disease. Acromegaly is common in adulthood, but people can be diagnosed at any age. The disease affects both genders equally, and the diagnosis for women is around 45 and 40 for men. The highest percentage of acromegaly cases are caused by adenomas and other tumors that cause excessive production of the hormone-releasing hormone (GHRH) (Adigun et al., 2023). Acromegaly develops gradually and is often noticed between 30 and 40. This has caused the condition to be misdiagnosed and underdiagnosed, leading to a delay in treatment. Moving forward, you will review the normal anatomy of the major body system affected, the normal physiology of the normal body system involved, and the mechanisms of pathophysiology, prevention, and treatment.

Normal Anatomy of the Major Body System Affected

The anatomy of the body system that is affected is the endocrine system. The endocrine system comprises the endocrine glands (Guarnotta et al., 2022). The specific organs affected by Acromegaly are the pituitary gland and skeleton. It is a small gland found in the lower region of the brain. It is made up of the anterior pituitary and the posterior pituitary. The anterior pituitary manufactures and releases hormones like GH. The skeleton is also affected. The normal anatomy of the skeleton is made up of normal-sized bones and cartilage and is divided into the axial and appendicular skeleton. The axial skeleton has the head and trunk regions. On the other hand, the appendicular skeleton is made up of bones that are found in the limbs and the bones that support the pelvic and pectoral girdles.

Normal Physiology of the Major Body System Affected

The normal physiology of the affected body system is when all the systems in the body are functioning correctly. Acromegaly is a hormonal condition that affects the endocrine system. The endocrine system is comprised of the endocrine glands. Its primary function is producing hormones and regulating other bodily functions like metabolism (Guarnotta et al., 2022). Acromegaly causes an overproduction of GH that triggers excess insulin-like growth factor 1 (IGF-1) production. This leads to various physiological changes. The normal physiology of the skeletal system offers mechanical support, and protection, aid in movement, store calcium, produce blood cells, and regulate the endocrine system.

Mechanisms of Pathophysiology

There are various mechanisms of pathophysiology of acromegaly, which are caused by the overproduction of the growth hormone and insulin-like growth factor. The first mechanism is a pituitary adenoma. A pituitary adenoma is a growth that occurs in the pituitary gland causing the pituitary gland to overproduce the growth hormone (Adigun et al., 2023). This interrupts normal metabolism and growth rates. A pituitary adenoma is considered the common cause of acromegaly. The second mechanism is GH and IGF-1. Excessive production of GH causes the liver to produce more IGF-1, a hormone that promotes growth in the tissues and organs. An increase in the level of IGF-1 in the blood increases abnormal growth rates, which leads to acromegaly.

The third mechanism is insulin resistance. High levels of GH and IGF-1 in the body risk insulin resistance. This is an event where the cells in the body fail to respond to inulin and its effects. Insulin plays a critical role in regulating the levels of blood sugar in the body. Insulin resistance interferes with blood sugar tolerance which triggers the production of more insulin. According to Moustaki et al (2023), insulin resistance causes diabetes mellitus, one of the signs of acromegaly.

The fourth mechanism is a genetic mutation. Acromegaly is sometimes found in some families, but there is no evidence that shows it can be inherited from parents. It often develops because of genetic mutations in the cells of the pituitary glands. The genetic mutation causes uncontrolled growth of cells creating a noncancerous tumor in the pituitary gland. The fifth mechanism is other medical conditions. There are some medical conditions that increase the vulnerability to developing acromegaly, like type 2 diabetes, hypertension, arthritis, and diseases of the heart muscle.

Prevention

There are some measures that can be implemented to prevent acromegaly. One should always get regular checkups. Going for routine checkups helps monitor health and detect the disease early; this allows early interventions and could help any further complications. Another prevention measure is hormonal screening. People who have experienced acromegaly in their family need hormonal screening (Adigun et al., 2023). This helps to determine the levels of GH and IGF-1 in the blood and assess if they are within normal range.

Next, is being aware of the symptoms. Learning and understanding the symptoms of acromegaly helps because a person will be able to seek timely medical care. Lastly, a preventative measure is genetic counseling. This is done to people with a history of acromegaly in their families. Genetic testing is conducted to determine any abnormalities.

Treatment

Acromegaly can be treated using surgeries, medication, and radiation. Surgeries, specifically transsphenoidal surgery, is done in this condition. The surgery involves removing the pituitary adenoma using a small cut in the upper lip or nasal passage (Adigun et al., 2023). Once the tumor is removed, the pituitary gland produces normal GH levels. Medications like somatostatin analogs and dopamine Agonists are used to treat acromegaly. In addition, radiation therapy is used to remove the tumor. This is achieved by destroying or shrinking the tumor in the pituitary glands to balance the levels of GH produced.

Conclusion

Acromegaly is a rare disease that causes excessive production of growth hormones manufactured by the anterior pituitary gland. The disease is rare, and it affects a small population worldwide. The anatomy of the body system that is affected is the endocrine system. The organs affected by acromegaly are the pituitary gland and skeleton. The normal physiology of the endocrine system is to produce hormones and regulate other body functions like metabolism. Mechanisms of the pathophysiology of acromegaly are pituitary adenoma, GH and IGF-1, insulin resistance, genetic mutation, and some medical conditions. Acromegaly can be prevented through regular checkups, hormone screening, a lookout for symptoms, and genetic counseling. The treatments are surgeries, medication, and radiation. Understanding the anatomy and physiology of acromegaly helps inform the best disease prevention and treatment interventions.

References

Adigun, O., Nguyen, M., Fox. T. & Anastasopoulou, C. (2023). Acromegaly.National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK431086/.

Guarnotta, V., Amodei, R., Frasca, F., Aversa, A., & Giordano, C. (2022). Impact of Chemical Endocrine Disruptors and Hormone Modulators on the Endocrine System.  International Journal of Molecular Sciences,  23(10), 5710.

Moustaki, M., Paschou, S. A., Xekouki, P., Kotsa, K., Peppa, M., Psaltopoulou, T., & Vryonidou, A. (2023). Secondary diabetes mellitus in acromegaly.  Endocrine, 1-15.