Overview
What are gigantism and acromegaly?
What are the signs and symptoms of gigantism?
What are the signs and symptoms of acromegaly?
Which lab tests are performed in the workup of gigantism and acromegaly?
Which imaging studies are performed in the workup of gigantism and acromegaly?
Which therapies are used in the treatment of gigantism and acromegaly?
What are growth hormone (GH) and insulinlike growth factor (IGF-I)?
What causes gigantism and acromegaly?
Which conditions are associated with gigantism?
What is the most common cause of acromegaly?
What is the pathophysiology of gigantism and acromegaly?
What is the prevalence of gigantism and acromegaly?
What is the prognosis of gigantism?
What is the prognosis of acromegaly?
What are the possible metabolic and endocrine complications of gigantism and acromegaly?
What are the possible respiratory complications of gigantism and acromegaly?
What are the possible cardiovascular complications of gigantism and acromegaly?
What are the possible bone metabolism complications of gigantism and acromegaly?
What are the possible neuromuscular complications of gigantism and acromegaly?
Which cancer risks are increased in gigantism and acromegaly?
What are the mortality rates associated with gigantism and acromegaly?
Where are patient education resources about gigantism and acromegaly found?
Presentation
Which clinical history findings are characteristic of gigantism?
Which clinical history findings are characteristic of acromegaly?
Which physical findings are characteristic of gigantism?
Which physical findings are characteristic of acromegaly?
DDX
Which conditions are included in the differential diagnoses of gigantism?
What is McCune-Albright syndrome?
How is pseudoacromegaly differentiated from acromegaly?
How is pachydermoperiostosis syndrome differentiated from acromegaly?
What are the differential diagnoses for Gigantism and Acromegaly?
Workup
What is the role of an oral glucose test in the workup of gigantism and acromegaly?
What is the role of GH testing in the workup of gigantism and acromegaly?
What is the role of IGF-I testing in the workup of gigantism and acromegaly?
What is the role of MRI in the workup of gigantism and acromegaly?
What is the role of CT scanning in the workup of gigantism and acromegaly?
What is the role of radiography in the workup of gigantism and acromegaly?
What is the role of IV TRH testing in the workup of gigantism and acromegaly?
What is the role of circulating GHRH blood measurement in the workup of gigantism and acromegaly?
Which histologic findings are characteristic of gigantism and acromegaly?
Treatment
How are gigantism and acromegaly treated?
What is the role of medications in the treatment of gigantism and acromegaly?
What is the role of somatostatin analogues in the treatment of gigantism and acromegaly?
What is the role of dopamine-receptor agonists in the treatment of gigantism and acromegaly?
What is the role of bromocriptine in the treatment of gigantism and acromegaly?
What is the role of cabergoline in the treatment of gigantism and acromegaly?
What is the role of GH-receptor antagonists in the treatment of gigantism and acromegaly?
What is the role of radiation therapy in the treatment of gigantism and acromegaly?
What is the role of surgery in the treatment of gigantism and acromegaly?
What is included in long-term monitoring of gigantism and acromegaly?
Guidelines
Which organizations have issued guidelines on the treatment of gigantism and acromegaly?
What are the ENDO guidelines on the diagnosis of gigantism and acromegaly?
What are the ENDO guidelines on the treatment of gigantism and acromegaly?
What are the ENDO treatment guidelines for gigantism and acromegaly during pregnancy?
Medications
Which medications are used in the treatment of gigantism and acromegaly?
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Gigantism and Acromegaly. Image shows a coauthor of this article with a statue of Robert Wadlow, who was called the Alton giant. The tallest person on record, he was 8 feet 11 inches tall at the time of his death.
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Gigantism and Acromegaly. A 12-year-old boy with McCune-Albright syndrome. His growth-hormone excess manifested as tall stature, coarse facial features, and macrocephaly.
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Gigantism and Acromegaly. Robert Wadlow, 19 years of age, with his father (postcard photo prior to 1937). Courtesy of Wikimedia Commons (https://commons.wikimedia.org/wiki/File:Robert_Wadlow_postcard.jpg).