Gigantism vs Acromegaly: Key Differences, Causes & Treatments

What’s the Difference Between Gigantism and Acromegaly?

Growth hormone is crucial for metabolism in adults and children, promoting growth in children and maintaining body structure in adults.

Rarely does the pituitary gland release excessive growth hormone due to the occurrence of a non-cancerous tumour. This condition leads to the overgrowth of bones in children, resulting in children growing to an abnormal height, which is called gigantism.

However, in adults, the pituitary gland overproduces growth hormone over a longer time, resulting in acromegaly. Acromegaly causes bone growth, altered facial features, and swelling of feet and hands.

What is the cause of gigantism?

The leading cause of gigantism is a growth hormone–secreting pituitary adenoma (a benign tumour) that results in excessive growth hormone production before epiphyseal closure.Pituitary hyperplasia is a condition that causes the pituitary gland to enlarge and form symptoms of gigantism, but this is exceedingly rare.

Moreover, gigantism can develop due to rare genetic disorders that increase the risk of growth hormone-secreting pituitary tumours occurring. These are:

• McCune-Albright syndrome.
• Carney complex.
• Neurofibromatosis.
• Multiple endocrine neoplasia type 1 (MEN1); very rarely, MEN type 4 has been reported in association with pituitary tumours.
• GPR101 gene mutation.
   

What is the cause of acromegaly?

Most acromegaly cases are caused by a pituitary adenoma. In rare cases, a non-pituitary tumour (e.g., in the lungs or pancreas) can secrete Growth Hormone-Releasing Hormone (GHRH), which then stimulates the pituitary gland to overproduce growth hormone. However, genetic syndromes can contribute to the risk of acromegaly, such as:

• Familial isolated pituitary adenoma
• Carney complex
• Multiple endocrine neoplasia type 1
• McCune-Albright syndrome
   

What are the differences in clinical presentation between gigantism and acromegaly?

Clinical presentation of gigantism may involve the following:

• Enlargement of feet and hands
• Thick toes and fingers
• Growth in height and muscles
• Puberty delay
• Prominent jaw and forehead
• Increased sweating
• Vision difficulties
• Irregular menstrual cycle
• Fatigue and weakness
   

On the other hand, acromegaly symptoms may include the ones stated below:

• Growth in feet and hands
• Teeth misalignment
• Enlarged tongue, jaw,and lips
• Muscle weakness
• Joint pain
• Thickened vocal cords that cause a husky, deeper voice
• Obstructive sleep apnea
• Hypertension
• Carpal tunnel syndrome
• Trapped nerves
• Excess body hair
• Headaches
   

How to Treat Gigantism and Acromegaly?

Gigantism typically presents with initially proportional overgrowth due to open growth plates, whereas acromegaly is characterized by acral and facial bone enlargement with coarse features after epiphyseal closure. Doctors may suggest different treatment options for both conditions, including:

1. Surgery: Transsphenoidal surgery accesses the tumour cells and the surrounding areas to remove pituitary tumours. It reduces growth hormone levels and alleviates basic symptoms.
2. Medications: Somatostatin analogues, dopamine receptor agonists, and growth hormone receptor antagonists are commonly prescribed medications. These drugs help to minimise pituitary tumour sizes and curb the secretion of growth hormone.
3. Radiation Therapy: If tumour cells recur in the pituitary gland or other body organs or have not been removed successfully, radiotherapy is recommended. This treatment strategy involves high-energy X-rays to destroy remaining tumour cells and slowly minimise the growth hormone levels.

Acromegaly and gigantism are rare syndromes of overproduction of growth hormone, but one occurs in childhood and the other in adults. Treatment of both acromegaly and gigantism focuses on controlling and removing the pituitary tumour, improving symptoms, regulating hormonal levels and treating the impact of growth hormones.

Reader Information: This article is intended for general informational and educational purposes only. Conditions such as gigantism and acromegaly are complex endocrine disorders that require evaluation and management by qualified healthcare professionals. Symptoms, causes, and treatment options may vary depending on individual health factors. Always seek the advice of a licensed physician or endocrinologist regarding any medical condition, symptoms, or treatment decisions.

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→ Acromegaly Causes and Symptoms

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→ Understanding Pituitary Dwarfism in Children

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