Detecting Acromegaly:
Know the Signs and Symptoms

The gradual onset and varied symptoms of acromegaly can make diagnosis challenging—especially as many of the initial signs of the disease can be attributed to other conditions. This is why acromegaly often has a delay in diagnosis that can be as long as 10 years.1,2

Patients often first seek medical advice for visual disturbances, rheumatologic issues, obstructive sleep apnea, menstrual dysfunction, infertility, or even dental disorders.2 Being aware of the chief clinical complaints of the disease can help you make a differential diagnosis.

Presenting Complaints of Acromegaly

The following complaints can result from either the physical effects of a pituitary tumor or as a consequence of the hypersecretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1)2-4:

  • Headaches
  • Visual impairment
  • Gigantism
  • Change in appearance, acral and soft tissue overgrowth:
    • Large fleshy lips and nose
    • Spade-like hands, frontal skull bossing, cranial ridges
    • Mandibular overgrowth, maxillary widening, teeth separation, jaw malocclusion, and overbite
    • Enlarged tongue, bones, salivary glands, thyroid, heart, liver, and spleen
    • Increase in shoe, ring, or hat size
  • Thyroid disorder
  • Diabetes mellitus, impaired glucose intolerance
  • Heart disease
  • Hypertension
  • Arthralgia and joint symptoms
  • Hyperhidrosis and oily skin
  • Skin tags
  • Thickened heel pads and coarsening of body hair
  • Carpal tunnel syndrome
  • Menstrual disorder in women
  • Impotence in men
  • Fatigue
  • Somnolence
  • Sleep apnea

Causes of Mortality in Acromegaly

Concomitant conditions account for an enhanced risk of mortality in patients with acromegaly. Among the diseases associated with acromegaly and increased risk of mortality are3,4:

  • Cardiac disease
  • Respiratory disease
  • Diabetes
  • Cancer

Diagnosing Opportunities by Specialty

As a result of the expansive number of symptoms associated with acromegaly, heightened awareness to the symptoms specific to your field of expertise is vital. By knowing what to look for and by working collaboratively with other healthcare professionals, you can help determine an accurate diagnosis.

Symptom2-4 Specialty
Teeth separation, jaw malocclusion, enlarged lips and tongue Dentistry
Headaches/sleep apnea Neurology
Visual impairment Ophthalmology
Increase in shoe size GP/podiatry
Diabetes GP/internal medicine/endocrinology
Heart disease/hypertension Cardiology/endocrinology
Joint symptoms/carpal tunnel
syndrome
Rheumatology
Hyperhidrosis GP
Menstrual disorder OB/GYN
Impotence Internal medicine/urology
References:
Lugo G, Pena L, Cordido F. Clinical manifestations and diagnosis of acromegaly. Int J Endocrinol. 12012;2012:540398.
Vilar L, Vilar CF, Lyra R, Lyra R, Naves LA. Acromegaly: clinical features at diagnosis. Pituitary. 2017;20(1):22-32.
Katznelson L, Laws ER Jr, Melmed S, et al. Acromegaly: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2014;99(11):3933-3951.
National Institute of Diabetes and Digestive and Kidney Diseases. Acromegaly. https://www.niddk.nih.gov/health-information/endocrine-diseases/acromegaly#treatment. Accessed April 27, 2017.
Resources for Professionals The more information you have about acromegaly, the better prepared you'll be to support your patients. Click here for a list of important resources.