Common Causes
Related Conditions
See more
What are the signs and symptoms of gigantism?
The signs and symptoms of gigantism are usually due to the excessive amount of growth hormone production and sometimes due to the pressure that larger adenomas may have within or in the brain areas close to the pituitary gland.
What is the cause of gigantism?
Gigantism is usually caused by a non-cancerous tumour in the pituitary gland (called a benign adenoma) that produces too much growth hormone. Pituitary tumours can be small in size (micro-adenoma) or large (macro-adenoma). However, in gigantism, they are frequently large and invade nearby brain tissue.
How common is gigantism?
Gigantism is an extremely rare condition, which most endocrinologists may come across only a couple of times in their whole careers. Only approximately six new cases occur each year in the United Kingdom.
How is gigantism diagnosed?
If gigantism is suspected, the diagnosis is usually confirmed by taking blood tests to measure the levels of growth hormone and insulin-like growth factor 1 (IGF1) circulating in the blood. IGF1 is released into the blood primarily by the liver in response to growth hormone.
Are there any side-effects to the treatment?
Side-effects from surgery can include haemorrhage, infection, loss of sense of smell or damage to the pituitary gland resulting in pituitary hormone deficiencies (hypopituitarism). Hypopituitarism is treated by replacing those hormones that are low, for example hydrocortisone ' or thyroid hormone tablets (see the article on hypopituitarism for further details).
Why do my feet get enlarged?
Enlargement of the feet due to pituitary hyperfunction (gigantism). Growth hormone is a key hormone, produced by the pituitary gland that regulates growth during childhood by promoting bone growth directly and helping to control the metabolism. This is a relatively stable process during childhood until puberty is reached.
What is the best way to monitor growth hormone levels after gigantism?
Following the diagnosis of gigantism, regular, long-term follow up by an endocrinologist is needed to monitor hormone levels (both growth hormone and IGF1). This helps to detect any tumour growth and screening for complications that might have occurred.
What causes gigantism in the pituitary gland?
Pituitary gigantism caused by growth hormone excess from infancy.
What is the treatment for gigantism?
Long-term treatment of gigantism with combination octreotide and bromocriptine in a child with McCune-Albright syndrome.
What is the role of G protein in endocrine cells?
The heterotrimeric G-proteins play an integral role in postligand signal transduction in many endocrine cells, in which they act by stimulating adenylyl cyclase, resulting in cAMP accumulation and subsequent gene transcription. Activating point mutations of the G-protein stimulatory subunit Gsα are known to form the basis for McCune-Albright syndrome (MAS), a rare disorder characterized by the classic triad of precocious puberty, café au lait spots, and fibrous dysplasia of bone ( 12 ). “Constitutive activation” refers to the autonomous and uncontrolled activation of G-protein-mediated cAMP formation that occurs in MAS, resulting in hyperfunction of endocrine and nonendocrine tissues. In some patients with MAS, endocrine abnormalities include gigantism caused by the development of pituitary mammosomatotroph adenomas or hyperplasia. The reported point mutations observed in multiple affected tissues of patients with MAS ( 13 ), including those with gigantism ( 14 ), involve a single amino acid substitution within codon 201 (exon 8) or codon 227 (exon 9) of the Gsα gene. Interestingly, these same mutations have also been identified in somatotrophs of up to 40% of sporadic GH-secreting pituitary adenomas ( 15 ). The resulting oncogene, gsp, is thought to induce tumorigenesis by virtue of persistent activation of adenylyl cyclase with subsequent GH hypersecretion ( 16 ). In contrast to tumors without such mutations, gsp -containing pituitary adenomas tend to be smaller, with morphologic characteristics suggestive of slow growth, despite an absence of detectable differences in disease progression between the two groups.
What causes GH to be elevated?
Excessive GH secretion has several potential causes and may occur in the context of a number of heterogeneous disorders. Among these, a variety of specific pathophysiologic mechanisms have been elucidated or proposed, all of which result in GH excess as the final common abnormality. Cases of GH hypersecretion may be subdivided into two main categories: those originating from a primary pituitary source and those that seem to be caused by increased GHRH secretion or dysregulation. A spectrum of pathologic pituitary morphology exists, ranging from isolated pituitary adenomas typically seen in cases of primary pituitary GH hypersecretion to pituitary hyperplasia, which is usually found in the context of prolonged GHRH excess. Although gigantism typically occurs as an isolated disorder, it may also be a feature of an underlying medical condition such as multiple endocrine neoplasia (MEN) type-1, McCune-Albright syndrome (MAS), neurofibromatosis, or Carney complex. The various etiologies of GH excess along with their associated characteristics are summarized in Table 1 and discussed further.
What is the difference between acromegaly and gigantism?
Gigantism refers to GH excess that occurs during childhood when open epiphyseal growth plates allow for excessive linear growth, whereas acromegaly indicates the same phenomenon occurring in adulthood. Although this review focuses primarily on gigantism, the two disorders may be thought of as existing along a spectrum of GH excess, with principal manifestations determined by the developmental stage during which such excess originates. Supporting this model has been the observation of clinical overlap between the two entities, with approximately 10% of acromegalics exhibiting tall stature ( 2) and the majority of giants eventually demonstrating features of acromegaly ( 3 ). The mean age for the onset of acromegaly is within the 3rd decade of life, whereas gigantism may begin at any age prior to epiphyseal fusion. Even a congenital onset of GH excess has been suggested by linear growth acceleration occurring within the first few months of life in young children with documented gigantism ( 4 – 6 ). The incidence of acromegaly is calculated to be three to four cases per million per year ( 7 ), whereas gigantism is extremely rare, with approximately 100 reported cases to date ( 2 ), although this is probably an underestimate of the true number.
What is the treatment for hypothalamic mass and gigantism in neurofibromatosis?
Hypothalamic mass and gigantism in neurofibromatosis: treatment with bromocriptine.
What causes a secondary GH excess?
Causes of secondary GH excess include those in which there is increased secretion of hypothalamic GHRH, either from an intracranial or ectopic source, and those in which abnormal regulation of the hypothalamic-pituitary GH axis has occurred . Secondary GH excess represents an important, if poorly understood, cause of gigantism. Advances in biochemical detection assays and molecular genetic characterization should allow improved localization of the underlying hormonal abnormality in these cases.
Why do we post questions on GARD?
Questions sent to GARD may be posted here if the information could be helpful to others . We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question
What causes a child to grow so much?
Other symptoms may include delayed puberty; double vision or difficulty with side (peripheral) vision; prominent forehead ( frontal bossing) and a prominent jaw; headache; increased sweating ( hyperhidrosis ); irregular periods; large hands and feet with thick fingers and toes; thickening of the facial features; and weakness. [1] It may begin at any age before epiphyseal fusion. [2] The most common cause is a non-cancerous (benign) tumor of the pituitary gland, which may cause it to make too much GH, but it can be caused by other underlying conditions (which may cause a pituitary tumor) including Carney complex ; McCune-Albright syndrome ; Multiple endocrine neoplasia type 1 (MEN-1) and type 4; and Neurofibromatosis. In some cases the disease is caused by mutations in the GPR101 gene. Treatment typically includes surgery to remove the tumor and can cure many cases. Medication or radiation therapy may be used to reduce GH release or block the effect of GH. [1]
What causes gigantism in the endocrine system?
Gigantism is caused by disease or disorder in those parts of the endocrine system that regulate growth and development. Androgen deficiency, for example, delays the closure of end plates, or epiphyses, of the long bones, which usually takes place when full growth is achieved.
When does gigantism start?
General gigantism usually starts before birth, and the oversized baby continues to grow at an accelerated rate. (In some instances, the existing hereditary predisposition for gigantism may not manifest until sometime during childhood.) In a reverse manner, general dwarfism may exist before birth, with the individual….
What is the term for a tumour of the pituitary gland?
Pituitary gigantism is usually associated with a tumour of the pituitary gland. Acromegaly ( q.v. ), a condition marked by progressive enlargement of skeletal extremities, occurs if growth hormone continues to be produced in large volume after epiphyseal closure.
Why are pituitary giants shorter than normal?
The life span of pituitary giants is shorter than normal because of their greater susceptibility to infection and metabolic disorders. Treatment by surgery or irradiation of the pituitary gland curtails further growth, but stature cannot be reduced once gigantism has occurred.
How tall is a pituitary gigantism?
In pituitary gigantism, growth is gradual but continuous and consistent; the affected person, with bones in normal proportion, may attain a height of eight feet. Muscles may be well developed but later undergo some atrophy or weakening.
Is gigantism a genetic disorder?
Gigantism associated with androgen deficiency is more frequent in men than in women and may be genetic. Another type of gigantism associated with endocrine disorder is pituitary gigantism, caused by hypersecretion of growth hormone (somatotropin), during childhood or adolescence, prior to epiphyseal closure.
How does gigantism affect the body?
Gigantism basically leads to an increase in the physical size and stature of the child eo is infected with this disease. But this is not the end of it. Gigantism has many other effects also, and most of them are negative. It leads to retardation of the mind. It also causes certain other problems which affect the pituitary gland too. Its octeroide may have a long term effect on the pituitary gigantism. It may lead to an analgesic effect on the mind and the body. The most harmful effect of gigantism is the occurrence of a correlated disease called Acromegaly.the effects of gigantism on other body parts are as follows:
What is a gigantism?
Gigantism Images. Gigantism refers to a particular growth defect, a condition which is characterized by an abnormal linear growth of the body, significantly above the normal one due to the over production of the growth hormone in the body. It is also known as the Exomphalos Macroglossia gigantism syndrome.
What hormone is involved in a person's growth?
Gigantism Hormone Involved. The hormone involved in this disease is the growth hormone gigantism. This hormone is secreted by the pituitary gland of the body. It is an essential hormone as it leads to the normal growth of the body. However excess of this hormone is harmful as it leads to gigantism.
What causes gigantism in the brain?
The pituitary gland is located at the base of the brain, and it is the root cause behind this disease. A hypothalamic condition, caused due to the excess activity of the pituitary gland overproduces the growth hormone, and this leads to gigantism . An adenoma of pituitary gland also causes this disease.
What is a growth disorder that causes an abnormal increase in physical size and stature?
Gigantism refers to an abnormal growth condition which originates during infancy, and shows itself through an abnormal increase in physical size and stature due to the excess of growth hormone.
How to remove pituitary tumor?
The most effective way of removing a pituitary tumor is through surgery. Surgery can be used for those tumors which have a well defined border. If it is not possible to surgically remove the tumor, then the patient has to resort to medication. Some of the other ways of treatment for gigantism include consumption of medicinesmedicines like Somatostatin, octeroide, and lareotide reduce the release of growth hormone.
How to diagnose gigantism?
The mehods by which you can diagnose this condition are: Taking a CT scan of the head or an MRI scan that shows the pituitary tumor.
What is it called when a child has too much growth hormone?
In children, too much growth hormone causes a condition called gigantism. rather than acromegaly. Gigantism occurs when excess GH begins before the end of puberty, when children’s growth plates fuse or close. Having too much GH before the growth plates close causes children to grow tall in height.
What hormones cause acromegaly?
When GH enters the blood, this signals the liver to produce another hormone, called insulin-like growth factor I (IGF-I). IGF-I is the hormone that actually causes bones and body tissue to grow.
What is acromegaly?
Acromegaly is a disorder that occurs when your body makes too much growth hormone (GH). Produced mainly in the pituitary gland, GH controls the physical growth of the body. In adults, too much of this hormone causes bones, cartilage, body organs, and other tissues to increase in size. Common changes in appearance include enlarged or swollen nose, ears, hands, and feet.
How common is acromegaly?
Acromegaly is rare. Scientists estimate that about 3 to 14 of every 100,000 people have been diagnosed as having acromegaly. 1
What are the symptoms of acromegaly?
Symptoms of acromegaly can vary from person to person. Common changes in physical appearance include
What is the best treatment for a tumor that is not located in the pituitary gland?
When the tumor that is creating too much GH is not located in the pituitary gland, other types of surgery are used to remove the tumor. Removing these nonpituitary tumors also lowers GH levels and improves acromegaly symptoms.
Why do acromegaly tumors develop?
In young adults, acromegaly has been linked to defects in certain genes.
