Causes and risk factors
The pituitary gland is responsible for the amount of growth hormone produced and released into the system. Growth hormone is secreted from anterior pituitary gland. Gigantism can be caused by a pituitary gland tumor. Other causes include neurofibromatosis, McCune Albright syndrome, multiple endocrine neoplasia type 1, Carney complex. When excess growth hormone is produced after the fusion of epiphyseal or growth plates, it is termed as acromegaly.
Clinical presentation
The affected child appears much larger than other children of the same age group. Certain body parts show disproportionate growth compared to the rest of the body. Hands and feet appear very large. Thickening of toes and fingers is seen. There is prominence of the jaw and forehead. Coarse facial features are observed. Flattened nose, large lips and tongue is seen. The person may complain of headaches, visual difficulties, deafness, nausea, weakness. There is profuse sweating. Delayed onset of puberty, irregular menstrual periods in females is experienced.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Measurement of serum growth hormone levels is done. Blood test to measure insulin growth factor-I [IGF-I] levels is required. Serum prolactin levels are obtained. Measurement of other hormones such as cortisol, estradiol, testosterone, and thyroid hormone is recommended. CT/MRI scans may be done to visualize a pituitary tumor.
Treatment
In case of pituitary gland tumor, surgical removal of the pituitary tumor is the treatment of choice. Medications are prescribed to either shrink the tumor or stop the production of excess growth hormone. Gamma knife radiosurgery includes radiation beams focused onto the tumor in order to destroy it. Hormone replacement therapy contributes further to the treatment.
Other Modes of treatment
The other modes of treatment can also be effective in treating gigantism. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating gigantism.
