Gigantism is a rare growth disorder causing excess of growth in children. It is due to the secretion of too much of growth factor IGF-1 and it occurs when the growth plates of the cartilages are kept opened during childhood. The child affected with gigantism will have unusually tall stature with abnormal growth of hands and feet with thick fingers. They would have coarse facial features with enlarged liver, heart and kidneys. There is no cure for this disorder but early intervention and prompt treatment can improve the quality of life. Medications and therapy will help the individual to cope with the daily demands of life. Acromegaly is a condition characterized by the same physical features but the changes do not occur instantly but it develops gradually over a period of time. Here the cartilages of the growth plates remain fused.
Gigantism Symptoms :
The child born with gigantism will be excessively tall and obese. He would have enlarged hands, legs and enlarged internal organs as well. He might have vision problems and have a chance of getting pituitary tumors. He might develop soft tissue hypertrophy and osteoarthritis later. He would possess coarse features with thick lips, protruding jaws, enlarged nose and wide spaced teeth. His skin would be excessively thick and oily and his voice would be husky due to enlargement of vocal cord.
He is likely to develop cardiovascular problems during adulthood. This disorder would also cause menstrual irregularity in women and erectile dysfunction in men. His skin would be excessively thick and oily and his voice would be husky due to enlargement of vocal cord. The only difference between acromegaly and gigantism is the signs and symptoms will be observed gradually in acromegaly whereas in gigantism it can be seen right from child-birth.
Gigantism Causes :
Gigantism is caused due to the excessive secretion of growth hormone IGF (insulin like growth factor). It is the growth hormone that triggers the secretion of IGF which is essential for normal growth of tissues and bones. But in children with gigantism abnormal amounts of growth factor is produced causing enlarged growth in bones and tissues.
In adults, gigantism can develop due to pituitary tumors. When the tumor exerts pressure on the scalp it can cause severe headaches and vision problems. For some people, non-pituitary tumors in lungs or pancreas can cause this disorder. In rare cases McCune Albright syndrome, Carney complex and neurofibromatosis can trigger excess secretion of growth hormone.
Gigantism can cause several health problems in addition to the damage done to the physical features. Many individuals with gigantism are likely to develop cardiovascular diseases, osteoarthritis, diabetes, hypertension, uterine fibroids, capital tunnel syndrome, and sleep apnea and vision problems. If not given prompt treatment the complications can cause life threatening problems.
The doctor will collect the medical history of the person apart from completing the physical examination. He would order for growth factor measurement tests like IGF-1, growth hormone suppression test and complete blood test. In addition he may order for imaging tests like CT or MRI scans to check if there are pituitary tumors.
Images, Pics, Photos and Pictures of Gigantism :
There is no cure for gigantism but treatment can be given for reducing the intensity of symptoms. Medications can be given to lower the level of growth hormone and to control the effects of pituitary tumor. Surgery can be done to remove the tumor using trans-sphenoidal procedure. Complete removal of pituitary tumor can regularize the secretion of growth hormone and reduce many of the symptoms. However the surgery carries risk and hence one has to choose expert surgeon. Even after surgery some people will have to go for radiotherapy and medications.
Medications are given to reduce the secretion of GH. Somatostatin analogues like sandostatin, lanreotide are prescribed. These drugs will arrest the excess secretion of growth hormones thus reducing its level. Initially the doctor will conduct a pre-testing to find out if the drugs are tolerated. Lanreotide drug is given in the form of injection and the dosage depends on the age and degree of symptoms. Dopamine agents like bromocriptine or cabergoline are effective in reducing the levels of GH. Growth hormone antagonist like pegvisomant is good in blocking the effects of growth hormone. Somavert is the brand name for this antagonist.
Radiation therapy is to be given for many patients after surgery for completely removing the tumor. It can be taken in the form of conventional method (weekly once) or as sterotactic method in which high doses of radiation are sent directly to the tumor. This procedure is called Gamma knife radiotherapy and is effective in normalizing the levels of GH. Factors like size, location of tumor and the levels of growth factor hormone are considered before selecting the right form of radio-surgery. Children born with gigantism should be given early treatment to prevent more damage to the organs and physical features.