Question

the nurse is caring for a patient with acromegaly. The patient asks why she is not growing to be a giant since she has increased growth hormone. what is the appropriate response by the nurse?

Answer 1

GIGANTISM refers to abnormally high linear growth due to excessive action of insulinlike growth factor-1 (IGF-1) while the epiphyseal growth plates are open during childhood. ACROMEGALY is the same disorder of IGF-1 excess but occurs after the growth plate cartilage fuses in adulthood.
In other words, gigantism is in the skeletally immature and is proportional whereas acromegaly occurs in skeletally mature people and only affects those bones that can keep growing.

Etiology and risk factors

Hyperpituitarism is defined as oversecretion of one or more of the hormones secreted by the pituitary gland it is caused primarily by a hormone secreting pituitary tumor, typically a benign adenoma. Syndromes associated with Hyperpituitarism are Cushing's syndrome, acromegaly, galactorrhea and so on.

Pathophysiology

Prolactin and growth hormone are the hormones most commonly overproduced by adenomas. They lead to hyperprolactinemia and acromegaly. Increased amounts of growth hormone lead to rapid growth of all body tissues. This increased growth leads to gigantism. If it occurs before closure of the epiphysis and acromegaly if it occurs after epiphyseal closure.

... Clinical manifestations of acromegaly.

Headache

Diplopia

Lethargy

Blindness

Goiter

Broadening of hands and feet due to gross increase in soft tissue

Increased ring and shoe size

Enlargement of visceral organs

Thickening of skull protruding supra orbital ridges.

Ciaresining of facial features.

Prognathism causing underbite

Cardiomyopathy

Diabetic mellitus

Enlaged but weak skeletal muscles

Thickened heel pads

.........................

Clinical features of gigantism

Excessive growth

The child is large for their age

Delayed puberty

Double vision or difficult with peripheral vision

Headache

Increased sweating

Large hands and feet

Thickening of facial features

Weakness

So these are difference of acromegaly and gigantism. Oversecretion of growth hormone usually from the pituitary, starting between the ages of 20 and 40,this is acromegaly.oversecretion of growth hormone usually from the pituitary, starting in childhood before fusion of the growth plates of bone,is gigantism.