In acromegaly there is excess growth hormone secondary to a pituitary adenoma in over 95% of cases. A minority of cases are caused by ectopic GHRH or GH production by tumours e.g. pancreatic.

Features

• coarse facial appearance, spade-like hands, increase in shoe size
• large tongue, prognathism, interdental spaces
• excessive sweating and oily skin: caused by sweat gland hypertrophy
• features of pituitary tumour: hypopituitarism, headaches, bitemporal hemianopia
• raised prolactin in 1/3 of cases → galactorrhoea
• 6% of patients have MEN-1

Complications

• hypertension
• diabetes (>10%)
• cardiomyopathy
• colorectal cancer