iCliniq logo

Ask a Doctor Online Now

HomeHealth articlesgrowth hormoneHow Is Gigantism Different From Acromegaly?

Gigantism - Causes, Symptoms, Diagnosis, and Management

Verified dataVerified data
0

4 min read

Share

Gigantism is a condition where there is abnormal growth in children due to excess production of growth hormone. Read the article to know more.

Medically reviewed by

Dr. Nagaraj

Published At September 14, 2022
Reviewed AtFebruary 13, 2024

Introduction:

The pituitary gland, located in the skull base, produces the growth hormone (GH). This gland produces or secretes a total of eight hormones. Apart from the growth hormone (GH), the other hormones secreted control the activity of the thyroid gland and the body temperature. GH performs various functions in the body, like promoting bone and muscle growth, controlling body fluids, regulating sugar and fat levels, and maintaining heart function.

What Is Gigantism?

Gigantism, also known as pituitary gigantism or pediatric acromegaly, is a rare condition in which the pituitary gland produces excess amounts of GH, which makes the child grow very tall when compared to peers. A tumor in the pituitary gland can trigger gigantism. GH, or somatotropin, stops increasing the height once the bones get fused at a certain age. Instead, it focuses on maintaining normal cartilage and bone structure. In gigantism, large amounts of GH cause a continued growth of bone, cartilage, and other soft tissues, which, when left untreated, can make the child attain a height of almost eight inches.

How Is Gigantism Different From Acromegaly?

In both gigantism and acromegaly, there is an excess production of GH. However, acromegaly affects adults, whereas gigantism affects children and teenagers. When there is an excess GH secretion before the bones fuse, it causes gigantism, and when it occurs after the bony plates have fused, it causes acromegaly. Gigantism is rare when compared to acromegaly.

How Common Is Gigantism?

Gigantism is an extremely rare condition that affects boys more when compared to girls.

What Are the Causes of Gigantism?

The primary cause of gigantism is a pituitary tumor called a pituitary adenoma, which is 10 mm (millimeters) or more in diameter. In addition, changes in the AIP gene can cause tumors in children.

The other genetic conditions that can form tumors in the pituitary gland, leading to increased production of GH, include:

  • McCune-Albright Syndrome: It is a disorder that affects skin, bones, and hormones, impacting growth and puberty.

  • Carney Complex: It is a disorder with an increased risk of developing different types of tumors.

  • Type 1 and Type 4 Multiple Endocrine Neoplasia: Genetic disorders in which the endocrine glands have an increased tendency to develop tumors.

  • Neurofibromatosis: It is a condition that affects the nervous system and skin. There is a growth of tumors all over the body, along the nerves, beneath the skin.

What Are the Symptoms of Gigantism?

In children affected with gigantism, there is an increase in height and a growth of muscles and organs. However, excessive growth makes the child look bigger when compared to their peers. Apart from increased growth, the other symptoms may occur due to pressure on the surrounding structures caused by the growing tumor.

The physical characters noted in children with gigantism include:

  • A rapid increase in height.

  • Prominent forehead and jaws.

  • Thick facial features.

  • Formation of gaps between the teeth.

  • Large hands and feet.

  • Thick fingers and toes.

Other symptoms that are noted in gigantism include:

  • Headache.

  • Joint pains.

  • Vision problems.

  • Excessive sweating.

  • Enlargement of organs like the heart.

  • Delay in puberty.

  • Irregular menstrual cycles.

  • Weakness of muscles.

  • Sleep disorders like insomnia and sleep apnea, where breathing gets interrupted during sleep.

  • Breast milk release.

What Are the Complications of Gigantism?

The common complication that occurs in patients with gigantism is hypopituitarism or a decrease in the function of the pituitary gland due to treatment procedures like surgery and radiation. As the pituitary gland produces many hormones, hypopituitarism can cause an imbalance in the hormonal levels, causing complications.

Complications that occur due to the surgery done to remove the pituitary gland can include bleeding, salt and water imbalance in the body, meningitis (an infection of the protective coverings of the brain), cerebrospinal fluid (CSF) leak (leakage of the fluid surrounding the brain and spinal cord).

Complications due to radiation therapy include loss of fertility, brain injury, loss of vision, and regrowth of tumors.

How Is Gigantism Diagnosed?

As gigantism is a rare condition, diagnosis can be difficult. Also, there may be a variation in the growth patterns of different children. Therefore, doctors may suggest specific blood tests and imaging tests after taking a medical and family history and doing a physical examination. The following tests help in diagnosing gigantism, which include:

  • Growth Hormone And IGF-1 (Insulin-Like Growth Factor 1) Tests: Determine the levels of GH and IGF-1 in blood. GH is released by the pituitary gland, whereas the liver secretes IGF-1. Elevated values of the above parameters indicate gigantism.

  • Oral Glucose Tolerance Test (OGTT) Test: Helps understand how the GH levels react to blood glucose in the body. The child has to drink a glucose solution, and the blood sugar levels are measured at regular intervals.

  • Imaging Tests: Like MRI (magnetic resonance imaging) scans and CT (computed tomography) are done to determine the size and location of pituitary tumors.

  • Other Tests: To check if other body parts are affected include:

    • ECG (Echocardiogram): This checks heart problems.

    • X-Rays or Dexa (Dual-Energy X-Ray Absorptiometry) Scan: To check bone health.

    • Sleep Tests: Help determine sleep apnea.

How Is Gigantism Managed?

The aim of treatment is to reduce or stop the production of excess GH by the child. The various options for treatment include:

1) Surgery:

Surgery is the preferred mode of treatment in cases where gigantism occurs due to a pituitary tumor. The surgeon removes the tumor by a minimally invasive technique. Microscopes or cameras can view the tumor while performing the surgery. Also, the child can return home a day after the surgery.

2) Medications:

Medications are considered in cases where surgery is not an option. Drugs shrink tumors or decrease the release of GH.

Octreotide or Lanreotide are medicines that prevent the release of GH, which are given as injections once every month. Bromocriptine and Cabergoline are the drugs used in pill form that act by lowering the GH hormone levels in the body. These medicines can be used in combination with Octreotide.

In conditions where the above drugs do not work, daily injections of Pegvisomant help decrease the effects of GH on the body. It also helps lower IGF-1 levels in the body.

3) Gamma Knife Radiosurgery: This is an option only when other treatments do not work. A collection of highly focused beams of radiation are passed onto the area of the tumor. These beams effectively destroy the tumor and do not harm the nearby structures. However, months or years of treatment may be necessary to successfully eliminate the tumor. Also, children receiving this therapy have side effects like obesity, emotional disturbances, and learning problems.

Conclusion:

Gigantism is an extremely rare condition that is caused mainly due to tumors in the pituitary gland. Early diagnosis and the start of treatment are pivotal in achieving better results. Surgery is the most preferred option for managing the condition. However, in cases where surgery is contraindicated, gigantism can be managed with medications, which reduce the symptoms and help the child lead a healthy and happy social life.

Frequently Asked Questions

1.

What Are the Consequences of Gigantism?

Gigantism is characterized by excessive growth and height due to the overproduction of growth hormones. The effects of gigantism are:
- Abnormally tall stature.
- Enlarged body parts and organs.
- Joint problems.
- Delayed puberty.
- Increased sweating.
- thickening of the skin.

2.

Is Gigantism Considered a Beneficial or Detrimental Condition?

Whether to consider gigantism a good (beneficial) or bad (detrimental) depends on individual perspectives and circumstances. Some see it as advantageous to be extremely tall, such as in sports or other professions. It is also associated with physical discomfort, medical challenges, and social difficulties. 

3.

Is There a Prompt Treatment for Gigantism?

Gigantism cannot be cured completely but can be managed and treated. The primary goal of the treatment is to control excessive Growth Hormone (GH) production and normalize growth. It is mostly achieved by surgical approach to remove or reduce the tumor causing overproduction of GH; radiation therapy and medications are also prescribed to regulate hormone levels.

4.

What Is the Typical Height Associated With Gigantism?

The height of an individual with gigantism varies but is known to reach over seven feet or more. The exact height varies from person to person.

5.

What Is an Alternative Name for Gigantism?

The alternative name for gigantism is ‘pediatric acromegaly’ or ‘giantism,’ commonly used while addressing adults. Acromegaly is a term similar to gigantism, but it occurs after the growth plates have closed, resulting in the enlargement of the body parts rather than an increase in overall height.

6.

At What Age Does Gigantism Typically Manifest?

Gigantism typically occurs during childhood and adolescence when the growth plates in the body's long bones are open and actively growing. Excessive growth hormone production during this period leads to increased bone growth and an abnormal increase in height. 

7.

Who Is Most Likely to Be Affected by Gigantism?

Gigantism is known to occur in males and females. A benign tumor called adenoma in the pituitary gland leads to overproduction of GH. it can develop in anyone but is relatively rare, with a prevalence of less than 1 in 10,000 individuals.

8.

Does Gigantism Impact Puberty?

Gigantism can affect puberty by delaying its onset. The excessive production of GH in individuals with gigantism can disrupt the normal timing of puberty, resulting in delayed sexual development and the appearance of secondary sexual characteristics.

9.

In Which Region Is Gigantism Most Prevalent?

Gigantism can occur in anyone and anywhere, but its prevalence is relatively low. There is no geographical region where gigantism is most common. However, gigantism can be encountered in different populations and ethnic groups globally.

10.

Why Do Individuals With Gigantism Have Shorter Lifespans?

The life expectancy is two to three times shorter than a normal individual in gigantism because of various factors, including cardiovascular problems, respiratory diseases, and certain risks of tumors. Untreated or poorly managed gigantism also leads to severe health issues that impact longevity.

11.

Can Gigantism Occur in Adults?

Gigantism generally occurs in childhood and adolescence and can also develop in adults. In adults, it manifests as acromegaly due to the overproduction of growth hormones similar to gigantism but does not cause an increase in height. Acromegaly is the enlargement of the body parts or organs that can lead to various health complications.

12.

Is Gigantism a Genetic Disorder?

Gigantism can have a genetic component. Certain genetic mutations or inherited conditions, such as multiple endocrine neoplasia type 1 (MEN1) and Carney Complex, can increase the likelihood of developing gigantism. However, not all cases of gigantism are solely genetic, as it can result from non-inherited factors such as pituitary tumors.

13.

When Was the First Case of Gigantism Documented?

In history, the first case of gigantism was identified in a third-dynasty Egyptian pharaoh by Galassi et al. There are several cases of gigantism and acromegaly throughout history who have been legends with extraordinary heights. Specific details need to be better documented, and some are unknown.

14.

How Rare Is Gigantism?

Gigantism is a relatively rare condition with less than one in 10,000 prevalence. It is not very commonly that is encountered in the general population. However, the prevalence varies depending on the various factors.
Dr. Nagaraj
Dr. Nagaraj

Diabetology

Tags:

growth hormonegigantism
Community Banner Mobile
By subscribing, I agree to iCliniq's Terms & Privacy Policy.

Source Article ArrowMost popular articles

Ask your health query to a doctor online

Internal Medicine

*guaranteed answer within 4 hours

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.

This website uses cookies to ensure you get the best experience on our website. iCliniq privacy policy