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Acromegaly: A Disease of Giant Proportions

Excess growth hormones cause some adults to suffer unusual bone lengthening

TUESDAY, June 25, 2002 (HealthDayNews) -- Her wedding ring no longer fit, her feet were tender, and she was gaining weight but not eating more.

Worse, she'd wake up every morning with a headache that felt like she'd been "hit with a frying pan."

Jill Meer of Newport Beach, Calif., had been suffering with the symptoms for about a year before she mentioned them in passing to her gynecologist at an annual exam. He told her it sounded like she had either rheumatoid arthritis or acromegaly, and immediately referred her to an endocrinologist.

The endocrinologist confirmed the diagnosis. Meer had acromegaly.

Acromegaly occurs when there's an excess amount of growth hormone in the adult body, usually due to a non-cancerous tumor in the pituitary gland.

Many people who are over 7 feet tall have acromegaly, says Dr. Shlomo Melmed, a professor of medicine and associate dean at the University of California at Los Angeles School of Medicine. Andre the Giant, a famous wrestler who stood 7-foot-4 and wore a size 22 shoe, had the disease.

The first symptom is usually a change in shoe size, Melmed says. Other symptoms include a growth in the hands, a change in ring size, joint pain, a change in facial features, swelling and headache. Left untreated, bone growth occurs that can permanently alter a patient's face, giving him or her a protruding jaw and forehead, or what Meer calls the "Neanderthal look."

Without treatment, the disease can cause diabetes, high blood pressure and heart disease, according to the National Institutes of Health. People with untreated acromegaly may also have a higher risk of colon cancer.

Approximately 20,000 adults in the United States have acromegaly, and because it's relatively rare, it can be hard to get a proper diagnosis. The average time from the first symptoms to diagnosis is about 10 years, Melmed says. During that time, irreversible damage can occur.

That's why Melmed spoke at the recent annual meeting of the Endocrine Society in San Francisco -- to raise awareness of the condition among physicians.

The disease is diagnosed from patient symptoms, blood tests for growth hormones and a CT or MRI scan. Once diagnosed, there are several treatment options, including drugs, surgery and radiation treatment.

"Acromegaly is a treatable, controllable disease," Melmed says. "If you don't treat it, it can cause premature mortality from heart or lung disease."

Which is probably what happened to Andre the Giant, who died nine years ago from heart disease at 46.

Meer was lucky. She got her diagnosis early and had her tumor removed. It eventually grew back, so she now controls the condition with drugs, but she suffered no permanent damage.

"It really is possible to live a happy, healthy life with acromegaly," she says.

What To Do

For more information on acromegaly, visit the National Institute for Diabetes and Digestive and Kidney Diseases or the University of Maryland Medicine.

SOURCES: Shlomo Melmed, M.D., professor, medicine, and associate dean, University of California at Los Angeles School of Medicine, chief academic officer, and director, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center, Los Angeles; Jill Meer, Newport Beach, Calif.
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