1. ACROMEGALY Acromegaly

2. it is a rare hormonal disorder that develops when the pituitary gland produces too much growth hormone.. Definition

3. Signs & Symptoms - - 1 st group is caused by the excess of growth hormone. - - 2 nd group is caused by the tumor. "benign“ *the symptoms are divide into 2 group :

4. 1 st group of symptoms  Swelling in feet and hand.  Thickening, sweaty and greasy skin.  Increased prominence of jaw or forehead and may both.  The vocal cords thicken that causes deepen in voice.  Tongue enlarge.  sleep apnea so ptt will have a poor sleep.  carpal tunnel syndrome causes pain, tingling and weakness in parts of hand.  Arthritis.  in woman may lead to irregular or even absence of the periods.

5.  Headaches.  Partial loss of vision may occur in one or both eyes.  damage of the normal cells which develop a lack of other hormones, leading to underactive of thyroid and adrenal gland which develops other symptoms. 2 nd group of symptoms

6. Causes :-  Over secretion of growth hormone.  ( IGF-1 ) !

7. Complication :- -High blood pressure (hypertension) -Heart disease, particularly enlargement of the heart muscle (cardiomyopathy) - Spinal cord compression - hypopituitarism “Reduced production of other pituitary hormones” -Visual field defects.

8. Testing and diagnosis :-  - blood test  - x-ray  - MRI  -Echocariogram  - no prenatal testing

9. Treatment :-  The main purpose of the treatment is to return grouth hormone and insuline like grouth factor- 1(IGF-1) levels as close to normal as possible to avoid serious complications  With successful treatment swelling and enlargement of soft tissue will gradually subside,but cant reverse excessive bone grouth

10.  Acromegaly is treated by surgery medication and radiation  First surgery : the causing disease tumor will be removed by transsphenoidal surgery.  Removing the tumor will return grouth hormone level to normal

11.  Medication:doctors may choose to manage acromegaly with medication if the tumor is inaccessible to surgery or if there is high risk of surgical complication or if the grouth hormone level still high after surgery.

12.  Radiation: its used if the tumor cells remain after surgery and medication is ineffective in reducing grouth hormone level.  Radiation therapy can quickly stop lingering tumor cells from growing and slowly reduce grouth hormone level.

13. By : Majid Muraishid Mohammed Dawood Muhanad Aljuhani Waleed Alqurashi