how many people have gigantism
Gigantism and acromegaly, growth hormone secreting pituitary gland, Department of (GH) too much, cause tissue, bone and visceral hypertrophy and hyperplasia of endocrine and metabolic disorders of the disease. Onset before puberty, epiphyseal closure were not for the Department of gigantism. onset of puberty, the epiphyseal closure by the Ministry acromegaly. most of the patients before the onset of puberty, to continue to develop the adult form "of acromegaly gigantism." symptoms of symptoms: excessive growth and height more in the 2m or so, the sustainable growth rate over 20 years of age. appetite strong, muscular, sexual Wang, in the recession, lack of energy, fatigue, back hunched, impotence, slow. gigantism as a detailed description of the symptoms occurred before puberty anterior pituitary hyperactivity disorder, strong growth hormone secretion, the cause is unknown. often continue the development of acromegaly. When children begin to grow too fast, 10-year-old can aly tall adult can continue to grow to around 30 years of age, height can be up to 240 cm tall, significantly higher than most people, muscle development, organ development early, strong sexual desire. When growth to peak physical condition gradually began to decline. basic treatment and drug therapy, radiotherapy, surgery. Also can take a variety of symptomatic treatment. patients should pay attention to the prevention and treatment of infection, to improve the prognosis of the disease. Why will produce
gigantism, the cause is still unknown at present, in the eyes of people behind the upper nasal cavity, there is a gland called the pituitary gland, secrete growth hormone, when the gland tumors in the brain, the cause of excessive growth hormone secretion, the formation of "gigantism", the function of growth hormone is to promote the development and growth of body tissues, which can promote the increase in the number of cells in the body and the larger so that the organs of the body parts of larger organizations, is an important factor in the growth of each individual in the growth process 2 of sexual characteristics, if excessive or too little growth hormone secretion can cause "gigantism," or "dwarfism." gigantism of treatment for the removal of pituitary tumors, excessive secretion of growth hormone reduce and maintain normal pituitary gland before and after pituitary function, to enable patients to obtain effective control of the disease; South Zhong, MD, shows that growth hormone The role of slow, so the patient''s appearance or body shape has changed and will be considered to be growth and development, increasing age, the relationship, without notice unusual form, called upon people to change if the shape characterization, weight, height abnormal increase, as soon as possible to find specialist examination.
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The names of diseases gigantism and acromegaly disease overof the disease is one of the anterior pituitary hyperthyroidism, occurs before puberty, epiphyseal fusion were not for the giant Ministry of disease, occurs after puberty, epiphyseal fusion by the Ministry for the limb has been hypertrophy. Mainly due to pituitary growth hormone cell adenoma or hyperplasia, excessive secretion of growth hormone, causing the soft tissue hypertrophy of epiphyseal and viscera, and endocrine and metabolic disorders. Disease in the country second only to non-functioning pituitary tumors and prolactinomas, pituitary tumors account for the third. The male to female ratio of 1.3-2.2:1. Age of onset acromegaly in up to 20-29 years of age. The cause is mainly due to pituitary growth hormone cell adenoma or hyperplasia, excessive secretion of growth hormone, causing the soft tissue hypertrophy of epiphyseal and viscera, and endocrine and metabolic disorders. Symptoms of the disease is one of the anterior pituitary hyperthyroidism, occurs before puberty, epiphyseal fusion were not for the giant Ministry of disease, occur during adolescence, the epiphyseal fusion of those for the Department has acromegaly. Mainly due to pituitary growth hormone cell adenoma or hyperplasia, excessive secretion of growth hormone, causing the soft tissue hypertrophy of epiphyseal and viscera, and endocrine and metabolic disorders. Disease in the country second only to non-functioning pituitary tumors and prolactinomas, pituitary tumors account for the third. The male to female ratio of 1.3-2.2:1. Age of onset acromegaly in up to 20-29 years of age. Diagnosis Diagnosis is based on three factors: (1) typical appearance, and other systemic signs of acromegaly and sellar compression; (2) imaging examination revealed the skull, the segment changes, and CT and magnetic resonance imaging and other findings; (3) endocrine - evidence of metabolic disorders. Baseline plasma GH levels more than 10 g / L, and from high blood glucose (oral glucose 50-100g) inhibition; or exciting experiments for TRH, growth hormone significantly increased, while the normal people are not increased. Measuring growth in recent years, interleukin-C (IGF-1) showed significantly higher (normal is 75-200 g / L) results cranial CT and magnetic resonance imaging is still normal and clinically suspicious, should be further searched for CT and other chest, abdomen GRH odor detection level of malignancy and to seek to clarify whether the odor of growth hormone, or CRH tumor. Differential diagnosis: (1) periosteal hypertrophy of skin to limbs, face, neck thick, wrinkled skin is characterized by tibia and distal radius bone, periosteal thickening of the ankle and wrist joints causes significant hypertrophy, the young males, no growth hormone excess, such as the sella is not an important basis for identification; (2) vacuoles sella; (3) elevated with pituitary growth hormone outside the tumors, such as in the third ventricle ependymomas, etc.; (4) rare GRH tumor. Treatment of a drug treatment (a) dopamine agonists respond with normal contrast, bromocriptine can inhibit the secretion of growth hormone and prolactin in patients, but needs more doses to reduce side effects, to be from small doses (1.25mg ), the middle of a meal before going to bed or with food to begin once a day, after every 3-7 days to adapt to increased 1.25-2.5mg, getting up to requirements, and sometimes daily to be 60-70mg, 15mg or more generally orally 2-3 times, about 2 weeks after beginning to bear fruit, 2-after 3 months showed a significant effect, even the visible tumor regression, significantly lower growth hormone and prolactin, growth hormone can be reduced to about 25% of normal. The drug on growth hormone secretion is only a disincentive, so need to continue treatment for several years, and easy to relapse after drug withdrawal, Guchang be supplemented by surgery or radiation therapy, or surgery combined with the drug therapy, or both before and after operation before and after radiotherapy treatment can be effective. Common reactions are nausea, vomiting, constipation, dizziness, hypotension, erythema limb pain. (B) of the Austrian Code of somatostatin analogues such as peptide somatostatin its board rate of more long, each dose of 100 g, 3 times a day, about 6 months after the effective. After treatment, about 2 / 3 of patients with symptomatic improvement, IGF-1 decreased to normal, about 1 / 3 of patients with cancer see the small, side effects are nausea, vomiting, diarrhea, but in the course of the ease. (C) other drugs cyproheptadine 5 - HT can be reduced by antagonists of growth hormone levels, but long-term effect remains to be seen, around the target at the toe of estradiol, antagonist of growth hormone, and mitigate the symptoms, but effects on plasma growth hormone not, other drugs such as megestrol acetate, chlorpromazine, levodopa and other growth hormone to make dips, but long-term efficacy is not satisfactory, have been less. Second, external beam radiation therapy and internal irradiation of two. Growth hormone cells in 60% -90% of the more sensitive, can be formed or the progress of activities is of use. Indications for radiotherapy: 1. The tumor has not completely removed, growth hormone is still higher; 2. Frail, not surgery, and tumor growth hormone increases small and not obvious, external radiation dose mostly 45 - 50Gy, the total effective rate was 85%, the main side effects of the anterior pituitary gland function and the ground around the target, vision loss. A narrow field of vision, high intracranial pressure were banned. The disease can also be reflected -knife stereotactic treatment. Third, if after surgical treatment of visual impairment after radiation therapy to deepen, narrow field of vision increased, and no other lesions improved, with or without radiation therapy and vision has been seriously damaged, patients with refractory headache, increased intracranial pressure, pituitary apoplexy, diabetes or insulin resistance that indications for surgery in recent years, microsurgery, cryosurgery, surgery, transsphenoidal resection of small adenomas in full force, so the indications for surgery have been significantly relaxed, see chapter pituitary tumor, for large adenoma, mixed tumor of outside developers saddle can be hidden Pavilion bromine 3-6 months, if no improvement, but not reduced tumor growth hormone was still significantly higher than normal, compression symptoms who are still required to carry out surgery to improve postoperative symptoms, plasma growth hormone levels can also be down, but may not be fully restored to normal, continued to be followed by radiotherapy or bromocriptine or somatostatin analogues, surgical treatment of about 60% -80%, despite a large tumor craniotomy, less effective, surgical contraindications Card: 1. frail elderly with other diseases is not suitable for surgery; 2. severe sphenoid sinus infection. In conclusion, acromegaly treatment is still a difficult problem, various methods have advantages and disadvantages, the specific conditions required flexibility, bromocriptine and other drugs, although effective, but a larger dose, treatment and long, easy to relapse after stopping . Surgery faster, but most can not be completely removed, especially in large tumors, and often caused by pituitary dysfunction, although the external radiation is also effective, but requires high-precision equipment, effect of slow, -knife also need high-precision equipment, cost more , mainly for small tumors, generally young people often have a large tumor, the tumor activity of large, must early surgery, radiotherapy and drugs, small tumors may be asked to try drugs greenhouse material, if necessary, surgery, and thus follow the ideas of several joint treatment, Yangchangbuduan. In addition, pituitary dysfunction, or who have diabetes insipidus embolism group, should be using a variety of appropriate treatment, with severe headache, it should be pain, but avoid using addictive drugs. Complications, gigantism gigantism pure rare, often more than half of acromegaly secondary to the clinical manifestations can be divided into two phases: (a) usually begins with the early formation of the new-born infants to adults 10 years of age have been tall, and can continue growing up to 30 years old, height up to 240cm, muscular and a mighty, sex organs early, strong sexual desire, the higher basal metabolic rate of this period, glucose tolerance, diabetes may develop pituitary. (B) in patients with advanced recession to the peak growth, the gradual emergence of the early years began to decline, lack of energy, weakness, back getting rickets, hair loss, loss of libido, genital atrophy, mental deterioration, diabetes reduced, this period lasted about 4 - 5 years, more patients died, the average lifespans of more than 20 years of age only. Second, the slow onset of acromegaly, duration of up to 20 years. Clinical manifestations can be divided into two. (A) to form the age of onset of generally 20-30, at the beginning that looks too small, and typical face, head and facial tissue. Scalp nerve thickening, more than the amount of wrinkles, thickening of the lips, ear, nose grew large and thick tongue, voice, fuzzy, low voice. And subsequent proliferation of the head bone, resulting in lower jaw, eyes on the ridge, frontal bone and zygomatic arch were before the increase, prominent teeth, sparse and lower incisor teeth often come ahead with the disease than before, gradually looks ugly. Epiphyseal fusion of the Ministry has not increased, so the toe stubby fingers, hands, thick dorsal width. Broadening the spine, with osteoporosis, lumbar lordosis, causing low back pain. Rough skin thickening, multiple pigmentation and seborrhea, sweating, hirsutism. Patients often accompanied by high pressure and internal organs write hypertrophy. In recent years, found that the disease often accompanied by hyperprolactinemia, galactorrhea appeared both men and women, with sexual dysfunction; In addition, the often cranky irritability, headache, insomnia, nervousness, muscle pain and other symptoms. Cancer can still occur due to compression syndrome group. Physical examination also found that blood pressure, cardiac enlargement, arteriosclerosis, liver and spleen enlargement, diffuse or nodular thyroid enlargement. Test showed that plasma GH was significantly higher than the upper limit of normal, up to 10-100 times higher than with diagnostic value, usually in the 10-100 g / I, range. Normal adult value of plasma growth hormone-based 1-5 g / L. Men 2 g / L, the following women than men, children more than adults, and are subject to sleep, blood glucose, estrogens and other factors. Thyroid function was within normal range, high performance and growth hormone increase in metabolic rate related rather than caused by hyperthyroidism. Glucose tolerance in the normal range of basic, high performance and growth hormone increase in metabolic rate related rather than caused by hyperthyroidism. About half of those with impaired glucose tolerance, diabetes accounted for 27.5% showed resistance to insulin. Cholesterol, free fatty acids often high. Serum calcium normal, but often high phosphorus 1.45-1.77mmol / L (4.5-5.5mg/dl) between, suggesting that activity, mainly due to the oversupply of renal tubular reabsorption of phosphorus. Alkaline phosphatase normal. In addition to the imaging findings outside the sella increased thickening of the skull plate thickening, bone thinning, increased air sinus, mandibular growth, sparse teeth; long bones bony warts, finger (toe) side was flocculent and other features. Longer course of this period, up to 5-10 years. (B) the recession to the peak of disease progression, fading to listlessness, fatigue, forgetfulness, skin, muscle decay. Sexual organs and functions are impaired, and sometimes was part of the anterior pituitary hypofunction group, vision, vision impaired, accounting for half of the compression of the hypothalamus may be drowsiness, obesity, diabetes insipidus, such as performance. Diabetic ketoacidosis often late. Complications such as heart failure and secondary infection. Bromocriptine Octreotide related drugs cyproheptadine
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