Acromegaly and Gigantism: Compare and Contrast

Acromegaly and gigantism are two disorders that share a main characteristic: abnormal growth. Because of this similarity, many people confuse one for the other. However, these are two distinct, separate disorders that require their own diagnosis and treatment. That’s why this this article is here to perform a deep dive into the similarities and differences between acromegaly and gigantism.

Comparing and Contrasting

First, let’s get some of the major differences out of the way. A big one is the age of onset; gigantism impacts children whereas acromegaly tends to effect middle-aged adults. And no, gigantism does not turn into acromegaly when a child grows up.

Rarity is another. While both conditions are categorized as rare diseases, gigantism occurs in much fewer people, with the NIH estimating that the number of affected individuals in the U.S. sits around 100. When it comes to acromegaly, it’s a little more common, impacting 50 to 70 of every million people.

Now that we’ve gotten that out of the way, let’s dig a little deeper.

Causes

Here is a major commonality: cause. Both disorders are the result of a malfunctioning pituitary gland that produces too much growth hormone (GH). Most commonly, a benign pituitary adenoma (tumor) sits on the gland and is the reason for the excess GH production. However, there are other causes for each condition.

When it comes to gigantism, other possible causes include neurofibromatosis, GPR101 gene mutation, Carney complex, multiple endocrine neoplasia type 1 or 4, and McCune-Albright syndrome. Turning to acromegaly, a tumor is always the cause, but the location is what may vary. Tumors may form on the lungs, chest, adrenal glands, abdomen, hypothalamus, or pancreas.

Symptoms

Now, let’s turn to the effects of these two conditions. Let’s start with acromegaly. Affected individuals see slow-developing symptoms like:

  • Fatigue
  • Deeper voice
  • Enlarged feet, hands, lips, tongue, jaw
  • Thick and/or dark skin
  •  Oily skin
  • Misaligned teeth
  • Headaches
  • Insomnia
  • Muscle weakness
  • Pain and inflammation in the joints
  • Scoliosis
  • Difficulty breathing
  • Excess sweat
  • Skin tags
  • Excess body hair
  • Irregular heartbeat
  • Vision issues
  • Splayed fingers and toes
  • Spaces in between teeth

Turning to gigantism, these symptoms are apparent in childhood. They include:

  • Insomnia
  • Joint pain
  • Soft hands
  • Large hands and feet with thick toes and fingers
  • Enlarged jaw, tongue, nose, forehead, and lips
  • Underbite
  • Oily skin
  • Excess sweat
  • Deeper voice
    • This symptom is seen in males
  • Skin tags
  • Irregular menstrual periods
    • This symptom is seen in females
  • Headaches

When it comes to complications, gigantism and acromegaly share some while also having their own, distinct complications. Shared examples are high blood pressure, diabetes, heart disease, hypopituitariantism, and colon polyps. Complications unique to acromegaly are sleep apnea, arthritis, uterine fibroids, a compressed spinal cord, and issues with vision. Gigantism patients may see an enlarged heart leading to heart failure, thyroid cancer, hypothyroidism, and delayed puberty.

Diagnosis

The diagnostic process is where we see the most similarities between the two diseases. Doctors will begin with a comprehensive review of a patient’s medical and family history, and may utilize very similar tests. These include physical exams, imaging tests, and blood tests.

Treatment

Like diagnosis, there are a number of similarities within the treatment of gigantism and acromegaly. The goal is shared, and that is to lower the amount of GH. Possible treatment options for both conditions are surgery to remove the adenoma, medication to lower GH (e.g., dopamine agonists, somatostatin analogs, and growth hormone receptor antagonists), and radiation therapy. Additional treatment may be necessary to address any complications.

Long-term monitoring is also important, so patients with either condition should visit their doctor on a regular basis.

Takeaway

While there are many commonalities between acromegaly and gigantism, they are two distinct and separate conditions. It’s important to be able to recognize them as such, so that patients can receive the correct diagnosis and treatment, which will lead to the best outcomes.

You can find the source article at Healthline.

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