What is Gigantism and how is it caused?

Gigantism - causes, symptoms and treatment
on Thu 21 Jun

 

Your endocrine system is responsible for the regulation of your body’s metabolism, sexual development, reproduction, sleep, homeostasis, immunity and growth; and there are 8 hormone secreting glands in your body.  To find out more about this please see this blog post.

 

The pituitary gland is the one that manages growth and development so when it produces too much growth hormone (GH) after puberty– usually due to the presence of a benign tumour - this results in Acromegaly

 

However if this overproduction starts in infancy, childhood or adolescence it results in gigantism. This is much more rare than Acromegaly with an estimated worldwide incidence of 8 per million person-years and with the total number of cases only in the hundreds.

 

The causes of gigantism

There are actually two main causes of gigantism. The first, as described,  is the over production of GH – known as pituitary gigantism and this may either run in families or be as a result from a condition such as:

 

 

29% of patients with gigantism are found to have a DNA mutation in what’s called AIP. A study completed in 2017 revealed one in 150 people in Mid Ulster were found to carry this gene as compared to one in 2,000 in the rest of the UK.  This gene would have caused “Irish Giant” Charles Byrne to grow to more than 2.3m and was undoubtedly the basis behind the many tales of Irish Giants

 

The second cause is due to the presence of an overgrowth syndrome such as

  • Sotos Syndrome
  • Beckwith-Wiedemann Syndrome
  • Simpson Golabi-Behemel syndrome
  • Weaver Syndrome

 

The symptoms of gigantism

The main feature of gigantism is excessive height whereas acromegaly features excessive growth of the lower jaw, tongue and finger ends. This excessive height often starts at the age of 13 and may be accompanied by a head circumference that is greater than the 98th percentile or obesity.

 

The symptoms of gigantism are not dissimilar to acromegaly; both may feature headaches and disturbed vision which is caused by the effect of pituitary tumours. There is also likely to be excess sweating; mild to moderate obesity, osteoarthritis and joint pain

 

Additional features which are frequently encountered in gigantism include

  • A voracious appetite
  • Large hands and feet
  • A broad bridge to the nose
  • A prominent forehead
  • A protruding jaw
  • High blood pressure
  • Type 2 diabetes
  • Muscle weakness
  • Insomnia
  • Delayed puberty
  • Deafness

 

Treatment

The main goal of treatment is to prevent further linear growth.

 

As in acromegaly there are three types of treatment surgery, radiation or medical therapy (which is usually used alongside surgery/radiation) using either Somatostatin Analogues, Dopamine Agonists or GH Receptor Antagonists.

 

Unfortunately, complete disease control in a well progressed condition can be difficult to achieve and is only about 50% effective. For this reason - and for improved outcomes - early detection is vital and is dependent upon a blood test to measure growth hormone levels during an oral glucose test and measurement of IGF-1 which indicates excess GH production. An MRI scan of the Pituitary Gland is required and this will usually confirm the presence of a pituitary tumour.

 

I hope this has been helpful

 

For a detailed study of gigantism please see here.

 

 

Although every effort is made to ensure that all health advice on this website is accurate and up to date it is for information purposes and should not replace a visit to your doctor or health care professional.

 

As the advice is general in nature rather than specific to individuals Dr Vanderpump cannot accept any liability for actions arising from its use nor can he be held responsible for the content of any pages referenced by an external link

 

Tags

acanthosis nigricans Acromegaly Addison's disease adolescent diabetes problems adolescent thyroid problems Adrenal crisis adrenal fatigue Adrenal glands Anovulation artificial pancreas Autoimmune Thyroiditis Bariatric Surgery blood glucose levels blood pressure breastfeeding CAH Charcot foot cholesterol CHT coffee cold and flu medications Conception Congenital adrenal hyperplasia congenital hypothyroidism Consultant Endocrinologist London coronavirus cortisol covid-19 Cushing's disease Cushing's syndrome Depression Diabetes diabetes and bone health diabetes and heart health diabetes and oral health diabetes and parkinsons diabetes and sexual dysfunction diabetes and skin conditions diabetes and thrush diabetes in China diabetes insipidus diabetes latest diabetic ketoacidosis diabetic neuropathy Diabetic prevalence diabetic retinopathy diet for diabetes diet for obesity Disability Act Down's Syndrome Dr Mark Vanderpump e-consulting endocrine system fertility folic acid Freestyle Libre frozen shoulder and thyroid Fruit sugars gestational diabetes Gigantism Glucose Monitoring Glucose Tolerance Test gluten free Goitre Graves Disease Graves Orbitopathy guthrie test hair loss Hashimoto's Disease healthcare services hearing loss Heart Disease heel prick test Hepatitis C Hormones - most important how to lose weight hyperparathyroidism Hypersecretion Hyperthyroidism hyperthyroidism and respiratory problems Hypocalcaemia Hypogonadism hypoparathyroidism hypophysitis Hyposecretion Hypothyroidism hypothyroidism and respiratory problems IFG IGT immunotherapy side effects Impaired Fasting Glucose Impaired Glucose Tolerance Insulin Resistance Iodine IR iron Labour and birth late onset hypogonadism Levothyroxine Long Covid losing weight Low testosterone Mark Vanderpump MEN1 MEN2 menopause metabolic syndrome mood changes morning sickness Multiple endocrine neoplasia neuroendocrine tumour neuropathy Obesity obstructive sleep apnoea older patients online doctor OSA Osteoporosis overactive thyroid ozempic Pancreas Pancreatic Cancer Pancreatic Diabetes parathyroid glands Patient Resources Patient Support Groups PCOS PCOS and acne PCOS and fertility PCOS and Insulin PCOS diet Phaeochromocytomas Pituitary Gland POF Polycystic Ovary Syndrome Post menopause thyroid problem Post pregnancy thyroid problem postnatal diabetes medication postnatal thyroid medication Prader-Willi Syndrome pre-eclampsia prediabetes pregnancy Pregnancy and Diabetes Pregnancy and Thyroid Disease Premature Ovarian Failure prolactinomas PTH puberty Radioactive Iodine RAI resistant hypertension semaglutide Sheehan's Syndrome Skin tags sleep and diabetes sleep and obesity soy Soya steroid dependent subacute thyroiditis T4 Tara Palmer Tomkinson testosterone Tetany The endocrine system Thyroid thyroid and menstruation thyroid cancer Thyroid disease in children thyroid nodules Thyroid Storm thyroid tests Thyroiditis Thyrotoxic Periodic Paralysis Thyroxine TSH levels TSH Testing tumours Type 1 diabetes Type 2 Diabetes Type 3 diabetes underactive thyroid Vitamin B complex Vitamin D Waist circumference weight gain weightloss

Please get in touch

Phone: 07565 978310

Contact form