The gradual onset and varied symptoms of acromegaly can make diagnosis challenging –– especially as many of the initial signs of the disease can be attributed to other conditions. This is why acromegaly often has a delay in diagnosis that can be as long as 10 years.1
Patients often first seek medical advice for orthopedic or rheumatologic issues, cardiac events, or even dental disorders.1 Being aware of the chief clinical complaints of the disease can help you make a differential diagnosis.
Presenting Complaints of Acromegaly
The following complaints can result from either the physical effects of a pituitary tumor or as a consequence of the hypersecretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1).1
- Headaches
- Visual impairment
- Gigantism
- Change in appearance, acral and soft tissue overgrowth: 2,3
- Large fleshy lips and nose
- Spade-like hands, frontal skull bossing, cranial ridges
- Mandibular overgrowth, maxillary widening, teeth separation, jaw malocclusion and overbite
- Enlarged tongue, bones, salivary glands, thyroid, heart, liver, and spleen
- Increase in shoe, ring or hat size
- Thyroid disorder
- Diabetes mellitus impaired glucose intolerance
- Heart disease
- Hypertension
- Arthralgia and joint symptoms
- Hyperhidrosis and oily skin
- Skin tags
- Thickened heel pads and coarsening of body hair
- Carpal tunnel syndrome
- Menstrual disorder in women
- Impotence in men
- Fatigue
- Somnolence
- Sleep apnea
Causes of Mortality in Acromegaly
Concomitant conditions account for an enhanced risk of mortality in patients with acromegaly.1 Among the diseases associated with acromegaly and increased risk of mortality are:1
- Cardiac disease
- Respiratory disease
- Diabetes
- Cancer
Diagnosing Opportunities by Specialty
As a result of the expansive number of symptoms associated with acromegaly, heightened awareness to the symptoms specific to your field of expertise is vital. By knowing what to look for and by working collaboratively with other healthcare professionals, you can help determine an accurate diagnosis.
| Symptom | Specialty | ||
| Teeth separation, jaw malocclusion, enlarged lips and tongue | Dentistry | ||
| Headaches/sleep apnea | Neurology | ||
| Visual impairment | Opthalmology | ||
| Increase in shoe size | GP/Podiatry | ||
| Diabetes | GP/Internal Medicine/Endocrinology | ||
| Heart disease/hypertension | Cardiology/Endocrinology | ||
| Joint symptoms/carpal tunnel syndrome |
Rheumatology | ||
| Hyperhidrosis | GP | ||
| Menstrual disorder | OBGYN | ||
| Impotence | Internal Medicine/Urology | ||
