What is Gigantism?
What is Gigantism? Gigantism is an excess of growth hormone production in children that affects their height and weight. This condition is quite rare and occurs before the epiphyseal plate or the growth plate inside the bone closes. During the growth period, children affected by gigantism can have high sizes and weight that look above average. It is also the cause of gigantism is not easily recognized symptoms and was originally regarded as a phase of normal child growth.
Gigantism differs from the acromegaly conditions in adults because the production of excessive growth hormone occurs when the epiphyseal plate closes.
Causes of Gigantism
The most common cause of gigantism is a tumor of the pituitary gland or pituitary gland tumor located at the bottom of the brain. These glands play a role in sexual development, controlling body temperature, urine production and growth metabolism on the face, hands, and feet. The growth of tumors in the pituitary gland causes these glands to produce excessive growth hormone. Other causes of gigantism are:
- Carney complex, the growth of benign tumors in the endocrine glands, connective tissue and the appearance of darker spots on the skin. This condition is an inherited disease.
- Multiple endocrine neoplasia type 1, also known as MEN 1, is the growth of tumors in the pituitary gland, the parathyroid gland, and the pancreas. This disease is an inherited disorder.
- Neurofibromatosis, tumor growth in the nervous system and is a derivative disorder.
- McCune-Albright syndrome, unnatural growth of bone tissue, gland abnormalities, and appearance of light brown spots on the skin.
Symptoms of Gigantism
Gigantism has physical symptoms that can be recognized in children directly. One of them is the size of the child’s body is higher than other children his age. Some parts of the child’s body can have different proportions with other body parts on themselves, such as the growth of the hands and feet accompanied by thickening of the fingers. Other symptoms are prominent jaw and forehead, and flat nose. In addition, patients can also experience enlargement of the head, tongue, or lips.
The symptoms experienced depend on how large the tumor is in the pituitary gland because it can suppress the brain nerve. Patients may experience headaches, fatigue, nausea as a result of tumors, visual impairment, hearing loss, abnormal menstrual periods, and delayed puberty in children.
Diagnosis of Gigantism
Gigantism can be diagnosed through a series of laboratory tests. Doctors will perform tests to find out the levels of growth hormone and growth factors such as insulin-1 (IGF-1). Another possible test is the Oral Glucose Tolerance Test (TTGO) or a blood test to see if the growth hormone has increased production. The doctor will check the blood glucose levels, before and after the child is given a special glucose solution. A low glucose level will indicate a normal growth hormone condition while the same glucose levels indicate an excess of growth hormone production. To be able to confirm the diagnosis of a pituitary gland tumor, an MRI test may also be done so that the size and location of the tumor is obtained.
The amount of growth hormone that causes of gigantism can be handled by controlling its production. However, there has been no successful treatment therapy that controls the production of growth hormone in a stable manner. For pituitary gland tumors, transsphenoidal surgery may be performed as the first treatment effort.
Gamma ray therapy or gamma knife radiosurgery is another method of treatment performed to treat tumors in the brain. This therapy will expose hundreds of small radiation rays to the tumor. Although more effective and able to restore normal growth hormone levels, this therapy can risk the emergence of emotional disorders in children, obesity, and learning disabilities. This therapy is generally taken as an ultimate alternative if standard operating methods fail.
Gigantism treatment also uses drugs such as octreotide to prevent growth hormone production rate. The drug can be liquid and injected once a month. Dopamine receptor agonist drugs may be administered in pill form to reduce tumor size before surgical procedures are performed. Both types of drugs can be used together to reduce the level of growth hormone in patients. Drugs can be used to reduce symptoms of gigantism in children if surgical procedures are not successful or face the case of tumors that grow back.
Complications of Gigantism
Untreated gigantism or treatment with surgical procedures may lead to a decrease in other pituitary gland hormones so that people are at risk for certain diseases, such as decreased hormone secretion or physiological activity in the ovaries or testes (hypogonadism), growth retardation and mental development in children and adults As a result of low thyroid gland activity (hypothyroidism), adrenal insufficiency, and rare cases of diabetes insipidus.
Prevention of Gigantism
Prevention of gigantism is not known with certainty so that detecting symptoms as early as possible is an effort to prevent the occurrence of severe symptoms and complications in patients.