1051:
suggested that the better the growth hormone is controlled, the better the outcome. Upon successful surgical treatment, headaches and visual symptoms tend to resolve. One exception is sleep apnea, which is present in around 70% of cases but does not tend to resolve with successful treatment of growth hormone level. While hypertension is a complication of 40% of cases, it typically responds well to regular regimens of blood pressure medication. Diabetes that occurs with acromegaly is treated with the typical medications, but successful lowering of growth hormone levels often alleviates symptoms of diabetes. Hypogonadism without gonad destruction is reversible with treatment. Acromegaly is associated with a slightly elevated risk of cancer.
751:
720:
834:
903:, which stops GH production. The long-acting forms of these drugs must be injected every 2 to 4 weeks for effective treatment. Most people with acromegaly respond to this medication. In many people with acromegaly, GH levels fall within one hour and headaches improve within minutes after the injection. Octreotide and lanreotide are effective for long-term treatment. Octreotide and lanreotide have also been used successfully to treat people with acromegaly caused by non-pituitary tumors.
420:
41:
1000:
the skill and experience of the surgeon. The success rate also depends on what level of GH is defined as a cure. The best measure of surgical success is the normalization of GH and IGF-1 levels. Ideally, GH should be less than 2 ng/ml after an oral glucose load. A review of GH levels in 1,360 people worldwide immediately after surgery revealed that 60% had random GH levels below 5 ng/ml. Complications of surgery may include
448:
406:
970:(Somavert). By blocking the action of the endogenous growth hormone molecules, this compound is able to control the disease activity of acromegaly in virtually everyone with acromegaly. Pegvisomant has to be administered subcutaneously by daily injections. Combinations of long-acting somatostatin analogues and weekly injections of pegvisomant seem to be equally effective as daily injections of pegvisomant.
1210:, the last Mexican Governor of California (1801â1894), manifested acromegaly without gigantism between at least 1847 and 1858. Some time after 1858, signs of the growth hormone-producing tumor disappeared along with all the secondary effects the tumor had caused in him. He looked normal in his 90s. His remarkable recovery is likely an example of spontaneous selective
1025:
This treatment lowers GH levels by about 50 percent over 2 to 5 years. People monitored for more than 5 years show significant further improvement. Radiation therapy causes a gradual loss of production of other pituitary hormones with time. Loss of vision and brain injury, which have been reported, are very rare complications of radiation treatments.
950:. Side effects of these dopamine agonists include gastrointestinal upset, nausea, vomiting, light-headedness when standing, and nasal congestion. These side effects can be reduced or eliminated if medication is started at a very low dose at bedtime, taken with food, and gradually increased to the full therapeutic dose. Bromocriptine lowers GH and
707:(growth hormone-releasing hormone), the hormone that stimulates the pituitary to make GH. In these people, the excess GHRH can be measured in the blood and establishes that the cause of the acromegaly is not due to a pituitary defect. When these nonpituitary tumors are surgically removed, GH levels fall and the symptoms of acromegaly improve.
926:. With an aggressive adenoma that is not able to be operated on, there may be a resistance to octreotide and in which case a second generation SSA, pasireotide, may be used for tumor control. However, insulin and glucose levels should be carefully monitored as pasireotide has been associated with hyperglycemia by reducing insulin secretion.
664:, is not present at birth but is acquired during life. The mutation occurs in a gene that regulates the transmission of chemical signals within pituitary cells; it permanently switches on the signal that tells the cell to divide and secrete growth hormones. The events within the cell that cause disordered pituitary
1033:
The initial treatment chosen should be individualized depending on the person's characteristics, such as age and tumor size. If the tumor has not yet invaded surrounding brain tissues, removal of the pituitary adenoma by an experienced neurosurgeon is usually the first choice. After surgery, a person
1024:
Radiation therapy has been used both as a primary treatment and combined with surgery or drugs. It is usually reserved for people who have tumor remaining after surgery. These people often also receive medication to lower GH levels. Radiation therapy is given in divided doses over four to six weeks.
995:
to reach the nasal cavity, where the pituitary is located. Endonasal transsphenoidal surgery is a less invasive procedure with a shorter recovery time than the older method of transsphenoidal surgery, and the likelihood of removing the entire tumor is greater with reduced side effects. Consequently,
999:
These procedures normally relieve the pressure on the surrounding brain regions and lead to a lowering of GH levels. Surgery is most successful in people with blood GH levels below 40 ng/ml before the operation and with pituitary tumors no larger than 10 mm in diameter. Success depends on
869:
The goals of treatment are to reduce GH production to normal levels thereby reversing or ameliorating the signs and symptoms of acromegaly, to relieve the pressure that the growing pituitary tumor exerts on the surrounding brain areas, and to preserve normal pituitary function. Currently, treatment
1015:
Even when surgery is successful and hormone levels return to normal, people must be carefully monitored for years for possible recurrence. More commonly, hormone levels may improve, but not return completely to normal. These people may then require additional treatment, usually with medications.
1037:
If surgery does not normalize hormone levels or a relapse occurs, a doctor will usually begin additional drug therapy. The current first choice is generally octreotide or lanreotide; however, bromocriptine and cabergoline are both cheaper and easier to administer. With all of these medications,
1050:
Life expectancy of people with acromegaly is dependent on how early the disease is detected. Life expectancy after the successful treatment of early disease is equal to that of the general population. Acromegaly can often go on for years before diagnosis, resulting in poorer outcome, and it is
710:
In people with GHRH-producing, non-pituitary tumors, the pituitary still may be enlarged and may be mistaken for a tumor. Therefore, it is important that physicians carefully analyze all "pituitary tumors" removed from people with acromegaly so as to not overlook the possibility that a tumor
723:
Frequent serum GH measurements in normal subjects (left panel) demonstrate that GH can fluctuate between undetectable levels most of the time interspersed with peaks of up to 30 ÎŒg/L (90 mIU/L); in acromegaly (right panel) GH hypersecretion is continuous with no undetectable
978:
Surgical removal of the pituitary tumor is usually effective in lowering growth hormone levels. Two surgical procedures are available for use. The first is endonasal transsphenoidal surgery, which involves the surgeon reaching the pituitary through an incision in the
1041:
Radiation therapy is generally used for people whose tumors are not completely removed by surgery, for people who are not good candidates for surgery because of other health problems, and for people who do not respond adequately to surgery and medication.
2537:
Dal, Jakob; Leisner, Michelle Z; Hermansen, Kasper; Farkas, Dóra Körmendiné; Bengtsen, Mads; Kistorp, Caroline; Nielsen, Eigil H; Andersen, Marianne; Feldt-Rasmussen, Ulla; Dekkers, Olaf M; SÞrensen, Henrik Toft; JÞrgensen, Jens Otto Lunde (1 June 2018).
651:
A marked variation in rates of GH production and the aggressiveness of the tumor occurs. Some adenomas grow slowly and symptoms of GH excess are often not noticed for many years. Other adenomas grow rapidly and invade surrounding brain areas or the
360:
Acromegaly affects about 3 per 50,000 people. It is most commonly diagnosed in middle age. Males and females are affected with equal frequency. It was first described in the medical literature by
Nicolas Saucerotte in 1772. The term is from the
909:
Because octreotide inhibits gastrointestinal and pancreatic function, long-term use causes digestive problems such as loose stools, nausea, and gas in one third of people. In addition, approximately 25 percent of people with acromegaly develop
659:
Most pituitary tumors arise spontaneously and are not genetically inherited. Many pituitary tumors arise from a genetic alteration in a single pituitary cell that leads to increased cell division and tumor formation. This genetic change, or
157:, high cholesterol, heart problems, particularly enlargement of the heart (cardiomyopathy), osteoarthritis, spinal cord compression or fractures, increased risk of cancerous tumors, precancerous growths (polyps) on the lining of the colon.
746:
load, which is a very specific lab test, will confirm the diagnosis following a positive screening test for IGF1. A single value of the GH is not useful in view of its pulsatility (levels in the blood vary greatly even in healthy
1123:(1894â1946), American journalist and actor. A Hollywood favorite in B-movie horror films of the 1930s and 1940s. Hatton's disfigurement, due to acromegaly, developed over time, beginning during his service in World War I.
1883:
Renehan AG, O'Connell J, O'Halloran D, Shanahan F, Potten CS, O'Dwyer ST, Shalet SM (2003). "Acromegaly and colorectal cancer: a comprehensive review of epidemiology, biological mechanisms, and clinical implications".
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3171:
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may be used. Radiation therapy may be used if neither surgery nor medications are completely effective. Without treatment, life expectancy is reduced by 10 years; with treatment, life expectancy is not reduced.
946:. As tablets rather than injections, they cost considerably less. These drugs can also be used as an adjunct to somatostatin analogue therapy. They are most effective in those whose pituitary tumours cosecrete
1332:(1873â1943), noted for his hands that could comfortably stretch a 13th on the piano, was never diagnosed with acromegaly in his lifetime, but a medical article from 2006 suggests that he might have had it.
411:
Compared with the hand of an unaffected person (left), the hand of a person with acromegaly (right) is enlarged, with fingers that are widened, thickened and stubby, and with thicker soft tissue
825:
at an unusually high dose. It can also be caused by a selective post receptor defect of insulin signalling, leading to the impairment of metabolic, but preservation of mitogenic, signalling.
821:
is a condition with the usual acromegaloid features, but without an increase in growth hormone and IGF-1. It is frequently associated with insulin resistance. Cases have been reported due to
2383:
Yamamoto, Reina; Robert Shima, Kosuke; Igawa, Hirobumi; Kaikoi, Yuka; Sasagawa, Yasuo; Hayashi, Yasuhiko; Inoshita, Naoko; Fukuoka, Hidenori; Takahashi, Yutaka; Takamura, Toshinari (2018).
2891:
954:
levels and reduces tumor size in fewer than half of people with acromegaly. Some people report improvement in their symptoms although their GH and IGF-1 levels still are elevated.
3122:
1495:
1175:(Dalip Singh Rana), Indian professional wrestler, is best known for his tenure with WWE under the ring name The Great Khali. He had his pituitary tumor removed in 2012 at age 39.
2727:
991:
instruments. The second method is transsphenoidal surgery during which an incision is made into the gum beneath the upper lip. Further incisions are made to cut through the
775:
Other pituitary hormones must be assessed to address the secretory effects of the tumor, as well as the mass effect of the tumor on the normal pituitary gland. They include
263:
have closed. The initial symptom is typically enlargement of the hands and feet. There may also be an enlargement of the forehead, jaw, and nose. Other symptoms may include
632:. Expansion of the tumor may cause headaches and visual disturbances. In addition, compression of the surrounding normal pituitary tissue can alter production of other
2660:
343:. Surgery is usually the preferred treatment; the smaller the tumor, the more likely surgery will be curative. If surgery is contraindicated or not curative,
2588:
323:
of the pituitary is carried out to determine if an adenoma is present. If excess growth hormone is produced during childhood, the result is the condition
772:
are helpful in the diagnosis: GH levels are suppressed below 1 ÎŒg/L in normal people, and levels higher than this cutoff are confirmatory of acromegaly.
2602:
2637:
934:
For those who are unresponsive to somatostatin analogues, or for whom they are otherwise contraindicated, it is possible to treat using one of the
2919:
3543:
628:. These tumors produce excessive growth hormone and compress surrounding brain tissues as they grow larger. In some cases, they may compress the
2941:"Shedding Light on a Rare Disease : Woman Hopes O.C. Group Will Increase Awareness of Life-Threatening Effects of Excessive-Growth Illness"
3381:
2861:
1325:(1449â92) may have had acromegaly. Historical documents and portraits, as well as a later analysis of his skeleton, support the speculation.
3460:
2746:
2678:
311:. Acromegaly is rarely due to a tumor in another part of the body. Diagnosis is by measuring growth hormone after a person has consumed a
3323:
1376:
1648:
1617:
1586:
1552:
1487:
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Soft tissue swelling of internal organs, notably the heart with the attendant weakening of its muscularity, and the kidneys, also the
3148:
2361:
1106:, born Oded Ha-Carmeili (1936â1972), Israeli-born entertainer with gigantism and acromegaly, popularly known as "The Jewish Giant".
806:
administration allows for clear delineation of the pituitary and the hypothalamus and the location of the tumor. A number of other
3139:
2905:
703:. These tumors also lead to an excess of GH, either because they produce GH themselves or, more frequently, because they produce
3451:
2221:
Yaqub, Abid; Yaqub, Nadia (1 September 2008). "Insulin-mediated pseudoacromegaly: a case report and review of the literature".
3127:
2125:"Somatic GNAS mutation causes widespread and diffuse pituitary disease in acromegalic patients with McCuneâAlbright syndrome"
1198:, reigned 235â238). Descriptions, as well as depictions, indicate acromegaly, though remains of his body are yet to be found.
1204:(Maurice Tillet, 1903â1954), Russian-born French professional wrestler, is better known by his ring name, the French Angel.
1401:
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1517:
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swelling visibly resulting in enlargement of the hands, feet, nose, lips, and ears, and a general thickening of the skin
3441:
2036:
1114:
3470:
2652:
1714:
1642:
1611:
1580:
1546:
1929:"Risk of thyroid nodular disease and thyroid cancer in patients with acromegalyâmeta-analysis and systematic review"
742:
provides the most sensitive lab test for the diagnosis of acromegaly, and a GH suppression test following an oral
3316:
2892:"Ex-treinador de PezĂŁo, AndrĂ© Benkei explica doença do lutador e afirma: 'Ele jamais colocaria a saĂșde em risco'"
20:
2580:
1311:
1284:
1038:
long-term therapy is necessary, because their withdrawal can lead to rising GH levels and tumor re-expansion.
3365:
2606:
3563:
1844:"Diabetes in acromegaly, prevalence, risk factors, and evolution: data from the French Acromegaly Registry"
1307:
676:
316:
2629:
1129:(1952â2015), American actor. Best known for portraying Hugo Mojoloweski, George's occasional bodyguard on
3558:
1747:
Melmed S, Casanueva FF, Klibanski A, Bronstein MD, Chanson P, Lamberts SW, et al. (September 2013).
784:
776:
671:
Pituitary adenomas and diffuse somatomammotroph hyperplasia may result from somatic mutations activating
3289:
2940:
1572:
Growth
Hormone Related Diseases and Therapy: A Molecular and Physiological Perspective for the Clinician
656:, which are located near the pituitary. In general, younger people tend to have more aggressive tumors.
3484:
3309:
795:
550:
367:
255:
is a disorder that results in excess growth of certain parts of the human body. It is caused by excess
3081:
1241:
3548:
3436:
2675:"Richard "Jaws" Kiel, Famed Bond Movie Villain, Raises Awareness Oflife-Threatening Hormone Disorder"
2486:
Melmed S, Bronstein MD, Chanson P, Klibanski A, Casanueva FF, Wass JA, et al. (September 2018).
1259:
1182:
3553:
3513:
3213:
1181:(AndrĂ© Roussimoff, 1946â1993), French professional wrestler and actor, known for playing Fezzik in
754:
2540:"Cancer Incidence in Patients With Acromegaly: A Cohort Study and Meta-Analysis of the Literature"
2869:
1412:
1290:
963:
862:
141:
2754:
2674:
2256:
Nguyen KH, Marks JG (June 2003). "Pseudoacromegaly induced by the long-term use of minoxidil".
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Vortmeyer AO, GlÀsker S, Mehta GU, Abu-Asab MS, Smith JH, Zhuang Z, et al. (July 2012).
1351:
1322:
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producing excess growth hormone. In more than 95% of cases the excess production is due to a
222:
196:
136:
Enlargement of the hands, feet, forehead, jaw, and nose, thicker skin, deepening of the voice
2817:
Nawar RN, AbdelMannan D, Selman WR, Arafah BM (2008). "Pituitary tumor apoplexy: a review".
1842:
Fieffe S, Morange I, Petrossians P, Chanson P, Rohmer V, Cortet C, et al. (June 2011).
3498:
3397:
3056:
1940:
1249:
1799:
Laws ER (March 2008). "Surgery for acromegaly: evolution of the techniques and outcomes".
8:
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1357:
1329:
1315:
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1001:
807:
284:
154:
2385:"Impact of preoperative pasireotide therapy on invasive octreotide-resistant acromegaly"
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1944:
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1363:
3503:
3136:
3033:
3008:
2989:
2842:
2794:
2770:"Governor Pio Pico, the monster of California...no more: lessons in neuroendocrinology"
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2514:
2487:
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2436:
2198:
2173:
2149:
2124:
1963:
1928:
1909:
1824:
1773:
1748:
1687:
1211:
891:
The primary current medical treatment of acromegaly is to use somatostatin analogues â
736:, if the lab tests are positive, confirms or rules out the presence of this condition.
729:
131:
3196:
2976:
2959:
1178:
906:
Somatostatin analogues are also sometimes used to shrink large tumors before surgery.
620:
About 98% of cases of acromegaly are due to the overproduction of growth hormone by a
3518:
3446:
3431:
3332:
3224:
3038:
2981:
2834:
2799:
2561:
2519:
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2414:
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2314:
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2009:
1968:
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1901:
1865:
1816:
1778:
1710:
1679:
1638:
1607:
1576:
1542:
1264:
1060:
1008:, or damage to the surrounding normal pituitary tissue, requiring lifelong pituitary
935:
875:
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653:
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340:
304:
272:
210:
178:
119:
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1999:
1958:
1948:
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1671:
1338:, (1973â2005) American actor known best for his role as Karl the Giant in the 2003
1201:
1159:
899:(Somatuline). These somatostatin analogues are synthetic forms of a brain hormone,
850:
818:
61:
1662:
Pearce JM (September 2006). "Nicolas
Saucerotte: Acromegaly before Pierre Marie".
3416:
3264:
3218:
3143:
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1953:
1435:
1335:
1306:(Paul Wight), American professional wrestler and actor, known for his tenures in
1255:
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2095:
National Center for
Biotechnology Information, U.S. National Library of Medicine
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2058:
National Center for
Biotechnology Information, U.S. National Library of Medicine
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914:, which are usually asymptomatic. In some cases, octreotide treatment can cause
833:
3267:
3024:
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1218:
1131:
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1083:
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569:
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Usually normal (with treatment), 10 year shorter life expectancy (no treatment)
3180:
2785:
2504:
2401:
2384:
1812:
1764:
1675:
1416:
1112:(1932â1979), American actor. Best known for portraying Lurch in the TV sitcom
3537:
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2410:
1381:
1142:
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467:
Features that may result from a high level of GH or expanding tumor include:
457:
260:
124:
19:
This article is about the disease in humans. For the disease in animals, see
2309:
2292:
2027:
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J (8 April 2015).
962:
The latest development in the medical treatment of acromegaly is the use of
3402:
3042:
2985:
2838:
2803:
2581:"Paul Benedict dies at 70; actor from 'The Jeffersons' and 'Sesame Street'"
2565:
2523:
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2318:
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2234:
2207:
2158:
2102:
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2004:
1987:
1972:
1905:
1869:
1820:
1782:
1683:
1235:
1165:
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1120:
1103:
1096:(1874â1933), an English woman, who after developing acromegaly, toured the
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780:
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645:
637:
621:
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559:
508:
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300:
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2539:
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2013:
1897:
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419:
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2189:
2140:
1225:
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967:
943:
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583:
528:
504:
484:
477:
429:
280:
150:
40:
1860:
1843:
1749:"A consensus on the diagnosis and treatment of acromegaly complications"
1207:
1140:(1939â2014), actor, "Jaws" from two James Bond movies and Mr. Larson in
16:
Human disease that results in excess growth of certain parts of the body
3273:
1339:
1274:
1229:
1005:
896:
892:
803:
491:
453:
264:
217:
3163:
1794:
1792:
1081:(1938â2008), American actor. Best known for portraying Harry Bentley,
996:
endonasal transsphenoidal surgery is the more common surgical choice.
687:
In a few people, acromegaly is caused not by pituitary tumors, but by
668:
and GH oversecretion currently are the subject of intensive research.
3259:
2957:
2924:
1347:
1245:
1222:
947:
911:
822:
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641:
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resulting in a characteristic thick, deep voice and slowing of speech
387:
373:
327:
rather than acromegaly, and it is characterized by excessive height.
324:
233:
3301:
1258:, Dutch actor, 2.13 m (7.0 ft), is best known for playing
405:
3284:
3086:
Acromegaly
Support - Rare Disease Awareness, Education, and Support
1789:
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1303:
1279:
1097:
1068:
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915:
692:
661:
633:
471:
308:
268:
2960:"Acromegaly in Lorenzo the Magnificent, father of the Renaissance"
2958:
Lippi, Donatella; Phillipe
Charlier; Paola Romagnani (May 2017).
1746:
984:
923:
838:
837:
Site of action of the different therapeutic tools in acromegaly.
743:
447:
433:
336:
312:
206:
48:
Lower jaw showing the classic spacing of teeth due to acromegaly.
3207:
3137:
2011 American
Association of Clinical Endocrinologists Guideline
3175:
3131:
3082:"Dutch Acromegaly Patient Marjon van Iwaarden Shares Her Story"
2485:
2382:
1985:
1841:
1406:
992:
865:
and thus impairing the effects of GH on the different tissues.
91:
3006:
2122:
1986:
Melmed S, Jackson I, Kleinberg D, Klibanski A (August 1998).
951:
688:
606:
by the growth of pituitary adenoma leading to visual problems
379:
365:
2816:
2578:
460:
remaining after tumor removal and tissue swelling eliminated
2906:"TRT ban forces UFC headliner 'Bigfoot' Silva into surgery"
2171:
1926:
739:
704:
696:
103:
94:
85:
76:
2488:"A Consensus Statement on acromegaly therapeutic outcomes"
1927:
Wolinski K, Czarnywojtek A, Ruchala M (14 February 2014).
1075:
because of his peculiar features and spontaneous sympathy.
496:
Pronounced brow protrusion, often with ocular distension (
2536:
2172:
Salenave S, Boyce AM, Collins MT, Chanson P (June 2014).
966:
antagonists. The only available member of this family is
88:
67:
3007:
Ramachandran, Manoj; Jeffrey K Aronson (October 2006).
2653:"Irwin Keyes, Horror Movie Character Actor, Dies at 63"
1366:, Romanian former basketball player nicknamed The Giant
2728:"WWE Star Great Khali's Growth-Inducing Tumor Removed"
2544:
The
Journal of Clinical Endocrinology & Metabolism
2026:
1575:. Springer Science & Business Media. p. 400.
1541:. Springer Science & Business Media. p. 205.
1034:
must be monitored long-term for increasing GH levels.
957:
2920:"UFC title hopeful 'Bigfoot' Silva a real-life giant"
2437:"Clinical manifestations and diagnosis of acromegaly"
355:
70:
64:
3153:
3149:
Endocrine and
Metabolic Diseases Information Service
2178:
The Journal of Clinical Endocrinology and Metabolism
2129:
The Journal of Clinical Endocrinology and Metabolism
1992:
The Journal of Clinical Endocrinology and Metabolism
1346:, as well as for his appearances as a member of the
100:
73:
1707:
Andrews' Diseases of the Skin: Clinical Dermatology
82:
79:
2031:(19th ed.). McGraw Hill. pp. 2269â2271.
1603:Sleep Apnea: Pathogenesis, Diagnosis and Treatment
1534:
1300:, Russian politician and former professional boxer
1704:
983:wall. The wall is reached by passing through the
3535:
2579:Times Staff And Wire Reports (5 December 2008).
1063:(1932â1984), Italian character actor. Active in
768:GH levels taken 2 hours after a 75- or 100-gram
3009:"The diagnosis of art: Rachmaninov's hand span"
2434:
870:options include surgical removal of the tumor,
761:that caused acromegaly with compression of the
711:elsewhere in the body is causing the disorder.
2258:Journal of the American Academy of Dermatology
1801:Reviews in Endocrine & Metabolic Disorders
3317:
2088:
2051:
1988:"Current treatment guidelines for acromegaly"
1354:, where he was known as the Original Bigfoot.
1157:(1932â85), British actor. Known for roles in
922:and its analogues can inhibit the release of
511:(enlargement of the tongue) and teeth spacing
2747:"The French Angel was more man than monster"
2290:
2084:
2082:
1100:circuit as "the ugliest woman in the world".
2853:
2255:
1664:Journal of the History of the Neurosciences
675:, which may be acquired or associated with
275:. Complications of the disease may include
3324:
3310:
2767:
2220:
2029:Harrison's Principles of Internal Medicine
1482:
1480:
1478:
1476:
1474:
545:Problems with bones and joints, including
490:Generalized expansion of the skull at the
173:Excess growth hormone (hypersomatotropism)
39:
3032:
2975:
2793:
2555:
2513:
2503:
2462:
2452:
2400:
2308:
2197:
2174:"Acromegaly and McCuneâAlbright syndrome"
2148:
2091:"Anatomy, Head and Neck, Pituitary Gland"
2079:
2054:"Anatomy, Head and Neck, Pituitary Gland"
2020:
2003:
1962:
1952:
1859:
1772:
1472:
1470:
1468:
1466:
1464:
1462:
1460:
1458:
1456:
1454:
1028:
886:
813:
3121:) is being considered for deletion. See
3013:Journal of the Royal Society of Medicine
2938:
1564:
1562:
832:
749:
718:
267:, thicker skin, deepening of the voice,
2859:
1698:
3544:Endocrine-related cutaneous conditions
3536:
2627:
2621:
2441:International Journal of Endocrinology
1742:
1740:
1738:
1736:
1734:
1732:
1730:
1728:
1726:
1661:
1630:
1606:(2 ed.). CRC Press. p. 291.
1555:from the original on 8 September 2017.
1538:Fundamentals of Hand and Wrist Imaging
1451:
339:to remove the tumor, medications, and
290:
3331:
3305:
2939:McLellan, Dennis (27 December 1992).
2650:
2430:
2428:
2293:"Insulin-mediated 'pseudoacromegaly'"
1559:
861:act in the periphery by blocking the
395:
2699:
2591:from the original on 26 August 2016.
2337:The Lecturio Medical Concept Library
1798:
1705:James W, Berger T, Elston D (2005).
1651:from the original on 25 August 2016.
1620:from the original on 25 August 2016.
1599:
1589:from the original on 25 August 2016.
1169:, and many British television series
1019:
929:
615:
295:Acromegaly is usually caused by the
2630:"Floridian: In love with a monster"
2089:Ganapathy, M. K.; Tadi, P. (2022).
2052:Ganapathy, M. K.; Tadi, P. (2022).
1723:
1498:from the original on 27 August 2016
1377:Hypothalamicâpituitaryâsomatic axis
958:Growth hormone receptor antagonists
13:
3442:Isolated growth hormone deficiency
2819:Journal of Intensive Care Medicine
2744:
2725:
2479:
2435:Lugo G, Pena L, Cordido F (2012).
2425:
2364:from the original on 22 April 2016
1568:
640:and breast discharge in women and
356:Epidemiology, history, and culture
14:
3575:
3125:to help reach a consensus. âș
3104:
2862:"Playboy Interview: Tony Robbins"
2681:from the original on 10 July 2009
2663:from the original on 29 May 2016.
2640:from the original on 8 June 2016.
2605:. 30 January 2015. Archived from
1848:European Journal of Endocrinology
1637:. World Scientific. p. 501.
1634:Fragments of Neurological History
1535:Guglielmi G, Van Kuijk C (2001).
1294:, based on the Stephen King book.
1151:, the world's tallest living man.
1054:
624:of the pituitary gland called an
503:Pronounced lower jaw protrusion (
2291:Sam AH, Tan T, Meeran K (2011).
1278:, Lwaxana Troi's silent Servant
810:can result in similar problems.
539:
446:
418:
404:
60:
3456:Secondary adrenal insufficiency
3074:
3049:
3000:
2951:
2932:
2912:
2898:
2884:
2810:
2768:Login IS, Login J (July 2008).
2761:
2738:
2719:
2693:
2667:
2644:
2595:
2572:
2530:
2376:
2350:
2325:
2284:
2249:
2214:
2165:
2116:
2045:
1979:
1920:
1876:
1835:
682:
319:in the blood. After diagnosis,
21:Hypersomatotropism (veterinary)
2603:"Hope for Acromegaly Patients"
1886:Hormone and Metabolic Research
1655:
1624:
1593:
1528:
1510:
1436:Merriam-Webster.com Dictionary
1423:
1394:
1285:Star Trek: The Next Generation
881:
828:
1:
3366:Pituitary ACTH hypersecretion
3110:
2977:10.1016/S0140-6736(17)31339-9
2492:Nature Reviews. Endocrinology
2223:West Virginia Medical Journal
1387:
1192:
798:of the brain focusing on the
2860:Plaskin G (13 August 2013).
1954:10.1371/journal.pone.0088787
1045:
728:If acromegaly is suspected,
714:
553:due to bony overgrowth, and
474:â often severe and prolonged
436:widening, teeth spacing and
388:
374:
330:
317:insulin-like growth factor I
7:
1709:(10th ed.). Saunders.
1370:
1288:, and The Moonlight Man in
1090:English next door neighbour
785:adrenocorticotropic hormone
777:thyroid stimulating hormone
732:investigations followed by
378:) meaning "extremity", and
10:
3580:
3485:Central diabetes insipidus
3025:10.1177/014107680609901015
2730:. ABC News. Archived from
2333:"Acromegaly and Gigantism"
973:
644:in men because of reduced
551:nerve compression syndrome
525:may occur in these people.
380:
366:
335:Treatment options include
315:solution, or by measuring
18:
3491:
3479:
3437:Growth hormone deficiency
3424:
3415:
3390:
3374:
3348:
3339:
3239:
3157:
3057:"Misbehaving Pituitaries"
2786:10.1007/s11102-008-0127-1
2628:Duryea B (27 June 1999).
2505:10.1038/s41574-018-0058-5
2402:10.1507/endocrj.ej17-0487
2358:"Octreotide Side Effects"
1813:10.1007/s11154-007-9064-y
1765:10.1007/s11102-012-0420-x
1676:10.1080/09647040500471764
610:
572:, potentially leading to
242:
232:
216:
202:
190:
177:
169:
161:
140:
130:
118:
52:
47:
38:
33:
3514:Lymphocytic hypophysitis
3123:templates for discussion
2831:10.1177/0885066607312992
1321:It has been argued that
1212:pituitary tumor apoplexy
853:act at the level of the
755:Magnetic resonance image
677:McCuneâAlbright syndrome
636:, leading to changes in
2651:Dagan C (8 July 2015).
2310:10.14310/horm.2002.1306
1413:Oxford University Press
1242:AntĂŽnio "Bigfoot" Silva
964:growth hormone receptor
863:growth hormone receptor
859:GH receptor antagonists
349:GH receptor antagonists
307:. The condition is not
3142:29 August 2017 at the
2005:10.1210/jcem.83.8.4995
1238:, motivational speaker
1029:Selection of treatment
887:Somatostatin analogues
866:
847:somatostatin analogues
814:Differential diagnosis
770:glucose tolerance test
765:
759:pituitary macroadenoma
725:
555:carpal tunnel syndrome
534:Carpal tunnel syndrome
345:somatostatin analogues
227:GH receptor antagonist
192:Differential diagnosis
2557:10.1210/jc.2017-02457
1898:10.1055/s-2004-814150
1409:UK English Dictionary
1352:The Howard Stern Show
1328:Pianist and composer
1314:, WWE and currently,
1228:singer, composer and
918:due to the fact that
836:
781:gonadotropic hormones
753:
722:
223:Somatostatin analogue
197:Pachydermoperiostosis
3499:Empty sella syndrome
3471:LH/hCG insensitivity
2908:. 12 September 2014.
2706:The Avengers Forever
2270:10.1067/mjd.2003.325
2190:10.1210/jc.2013-3826
2141:10.1210/jc.2012-1274
1250:mixed martial artist
808:overgrowth syndromes
428:overgrowth leads to
273:problems with vision
3564:Pituitary disorders
3361:Hyperprolactinaemia
2894:. 23 December 2013.
2634:St Petersburg Times
2454:10.1155/2012/540398
1945:2014PLoSO...988787W
1861:10.1530/EJE-10-1050
1358:Marjon van Iwaarden
1330:Sergei Rachmaninoff
1010:hormone replacement
1002:cerebrospinal fluid
602:Compression of the
458:forehead protrusion
392:) meaning "large".
291:Cause and diagnosis
285:high blood pressure
246:3 per 50,000 people
155:high blood pressure
3559:Neuroendocrinology
3509:Sheehan's syndrome
3504:Pituitary apoplexy
3461:GnRH insensitivity
3240:External resources
2609:on 9 February 2019
1631:Pearce JM (2003).
1323:Lorenzo de' Medici
1183:The Princess Bride
878:of the pituitary.
867:
766:
730:medical laboratory
726:
396:Signs and symptoms
3531:
3530:
3527:
3526:
3519:Pituitary adenoma
3466:FSH insensitivity
3447:Hypoprolactinemia
3432:Kallmann syndrome
3411:
3410:
3398:Nelson's syndrome
3333:Pituitary disease
3299:
3298:
2945:Los Angeles Times
2585:Los Angeles Times
2395:(10): 1061â1067.
2389:Endocrine Journal
1892:(11â12): 712â25.
1439:. Merriam-Webster
1419:on 22 March 2020.
1265:The Addams Family
1191:, Roman emperor (
1115:The Addams Family
1061:Salvatore Baccaro
1020:Radiation therapy
936:dopamine agonists
930:Dopamine agonists
895:(Sandostatin) or
876:radiation therapy
855:pituitary adenoma
851:dopamine agonists
616:Pituitary adenoma
579:Colorectal cancer
565:Diabetes mellitus
519:hyperpigmentation
507:) with attendant
341:radiation therapy
305:pituitary adenoma
250:
249:
211:radiation therapy
179:Diagnostic method
28:Medical condition
3571:
3549:Growth disorders
3422:
3421:
3346:
3345:
3341:Hyperpituitarism
3326:
3319:
3312:
3303:
3302:
3155:
3154:
3098:
3097:
3095:
3093:
3078:
3072:
3071:
3069:
3067:
3061:Damn Interesting
3053:
3047:
3046:
3036:
3004:
2998:
2997:
2979:
2955:
2949:
2948:
2936:
2930:
2929:
2916:
2910:
2909:
2902:
2896:
2895:
2888:
2882:
2881:
2879:
2877:
2868:. Archived from
2857:
2851:
2850:
2814:
2808:
2807:
2797:
2765:
2759:
2758:
2753:. Archived from
2742:
2736:
2735:
2734:on 4 March 2016.
2723:
2717:
2716:
2714:
2712:
2697:
2691:
2690:
2688:
2686:
2671:
2665:
2664:
2648:
2642:
2641:
2625:
2619:
2618:
2616:
2614:
2599:
2593:
2592:
2576:
2570:
2569:
2559:
2550:(6): 2182â2188.
2534:
2528:
2527:
2517:
2507:
2483:
2477:
2476:
2466:
2456:
2432:
2423:
2422:
2404:
2380:
2374:
2373:
2371:
2369:
2354:
2348:
2347:
2345:
2343:
2329:
2323:
2322:
2312:
2288:
2282:
2281:
2253:
2247:
2246:
2218:
2212:
2211:
2201:
2169:
2163:
2162:
2152:
2120:
2114:
2113:
2111:
2109:
2086:
2077:
2076:
2074:
2072:
2049:
2043:
2042:
2024:
2018:
2017:
2007:
1983:
1977:
1976:
1966:
1956:
1924:
1918:
1917:
1880:
1874:
1873:
1863:
1839:
1833:
1832:
1796:
1787:
1786:
1776:
1744:
1721:
1720:
1702:
1696:
1695:
1659:
1653:
1652:
1628:
1622:
1621:
1600:Pack AI (2016).
1597:
1591:
1590:
1566:
1557:
1556:
1532:
1526:
1525:
1514:
1508:
1507:
1505:
1503:
1484:
1449:
1448:
1446:
1444:
1427:
1421:
1420:
1415:. Archived from
1398:
1364:Gheorghe MureÈan
1202:The French Angel
1197:
1194:
1089:
819:Pseudoacromegaly
450:
422:
408:
391:
385:
384:
377:
371:
370:
110:
109:
106:
105:
102:
97:
96:
93:
90:
87:
84:
81:
78:
75:
72:
69:
66:
43:
31:
30:
3579:
3578:
3574:
3573:
3572:
3570:
3569:
3568:
3554:Growth hormones
3534:
3533:
3532:
3523:
3487:
3475:
3452:ACTH deficiency
3417:Hypopituitarism
3407:
3386:
3370:
3335:
3330:
3300:
3295:
3294:
3235:
3234:
3166:
3144:Wayback Machine
3126:
3107:
3102:
3101:
3091:
3089:
3080:
3079:
3075:
3065:
3063:
3055:
3054:
3050:
3005:
3001:
2970:(10084): 2104.
2956:
2952:
2937:
2933:
2918:
2917:
2913:
2904:
2903:
2899:
2890:
2889:
2885:
2875:
2873:
2872:on 2 April 2015
2858:
2854:
2815:
2811:
2766:
2762:
2757:on 6 July 2015.
2751:SLAM! Wrestling
2743:
2739:
2724:
2720:
2710:
2708:
2702:"Neil McCarthy"
2698:
2694:
2684:
2682:
2677:. PR Newswire.
2673:
2672:
2668:
2649:
2645:
2626:
2622:
2612:
2610:
2601:
2600:
2596:
2577:
2573:
2535:
2531:
2484:
2480:
2433:
2426:
2381:
2377:
2367:
2365:
2356:
2355:
2351:
2341:
2339:
2331:
2330:
2326:
2289:
2285:
2254:
2250:
2219:
2215:
2170:
2166:
2121:
2117:
2107:
2105:
2087:
2080:
2070:
2068:
2050:
2046:
2039:
2025:
2021:
1984:
1980:
1925:
1921:
1881:
1877:
1840:
1836:
1797:
1790:
1745:
1724:
1717:
1703:
1699:
1660:
1656:
1645:
1629:
1625:
1614:
1598:
1594:
1583:
1567:
1560:
1549:
1533:
1529:
1516:
1515:
1511:
1501:
1499:
1486:
1485:
1452:
1442:
1440:
1429:
1428:
1424:
1400:
1399:
1395:
1390:
1373:
1360:, Dutch singer.
1336:Matthew McGrory
1256:Carel Struycken
1195:
1189:Maximinus Thrax
1179:André the Giant
1173:The Great Khali
1087:
1057:
1048:
1031:
1022:
976:
960:
932:
889:
884:
831:
816:
734:medical imaging
717:
685:
618:
613:
589:Thyroid nodules
542:
498:frontal bossing
465:
464:
463:
462:
461:
451:
442:
441:
440:
423:
414:
413:
412:
409:
398:
358:
333:
321:medical imaging
297:pituitary gland
293:
277:type 2 diabetes
259:(GH) after the
209:, medications,
185:medical imaging
147:Type 2 diabetes
114:
99:
63:
59:
29:
24:
17:
12:
11:
5:
3577:
3567:
3566:
3561:
3556:
3551:
3546:
3529:
3528:
3525:
3524:
3522:
3521:
3516:
3511:
3506:
3501:
3495:
3493:
3489:
3488:
3483:
3481:
3477:
3476:
3474:
3473:
3468:
3463:
3458:
3449:
3444:
3439:
3434:
3428:
3426:
3419:
3413:
3412:
3409:
3408:
3406:
3405:
3400:
3394:
3392:
3388:
3387:
3385:
3384:
3378:
3376:
3372:
3371:
3369:
3368:
3363:
3358:
3352:
3350:
3343:
3337:
3336:
3329:
3328:
3321:
3314:
3306:
3297:
3296:
3293:
3292:
3281:
3270:
3256:
3244:
3243:
3241:
3237:
3236:
3233:
3232:
3221:
3210:
3199:
3184:
3167:
3162:
3161:
3159:
3158:Classification
3152:
3151:
3146:
3134:
3106:
3105:External links
3103:
3100:
3099:
3073:
3048:
3019:(10): 529â30.
2999:
2950:
2931:
2911:
2897:
2883:
2852:
2809:
2760:
2737:
2718:
2692:
2666:
2643:
2620:
2594:
2571:
2529:
2498:(9): 552â561.
2478:
2424:
2375:
2349:
2324:
2283:
2248:
2213:
2184:(6): 1955â69.
2164:
2135:(7): 2404â13.
2115:
2078:
2044:
2038:978-0071802154
2037:
2019:
1998:(8): 2646â52.
1978:
1919:
1875:
1834:
1788:
1759:(3): 294â302.
1722:
1715:
1697:
1654:
1643:
1623:
1612:
1592:
1581:
1558:
1547:
1527:
1522:mayoclinic.org
1509:
1494:. April 2012.
1450:
1422:
1392:
1391:
1389:
1386:
1385:
1384:
1379:
1372:
1369:
1368:
1367:
1361:
1355:
1333:
1326:
1319:
1301:
1298:Nikolai Valuev
1295:
1268:film trilogy,
1253:
1239:
1233:
1219:Edmundo Rivero
1215:
1205:
1199:
1186:
1176:
1170:
1152:
1146:
1135:
1132:The Jeffersons
1124:
1118:
1107:
1101:
1094:Mary Ann Bevan
1091:
1084:The Jeffersons
1076:
1056:
1055:Notable people
1053:
1047:
1044:
1030:
1027:
1021:
1018:
975:
972:
959:
956:
931:
928:
888:
885:
883:
880:
830:
827:
815:
812:
716:
713:
701:adrenal glands
684:
681:
617:
614:
612:
609:
608:
607:
600:
595:
593:thyroid cancer
586:
581:
576:
570:Cardiomyopathy
567:
562:
557:
547:osteoarthritis
541:
538:
537:
536:
531:
526:
515:Hypertrichosis
512:
501:
494:
488:
481:
475:
452:
445:
444:
443:
424:
417:
416:
415:
410:
403:
402:
401:
400:
399:
397:
394:
357:
354:
332:
329:
292:
289:
257:growth hormone
248:
247:
244:
240:
239:
236:
230:
229:
220:
214:
213:
204:
200:
199:
194:
188:
187:
181:
175:
174:
171:
167:
166:
163:
159:
158:
144:
138:
137:
134:
128:
127:
122:
116:
115:
113:
112:
56:
54:
50:
49:
45:
44:
36:
35:
27:
15:
9:
6:
4:
3:
2:
3576:
3565:
3562:
3560:
3557:
3555:
3552:
3550:
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3542:
3541:
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3520:
3517:
3515:
3512:
3510:
3507:
3505:
3502:
3500:
3497:
3496:
3494:
3490:
3486:
3482:
3478:
3472:
3469:
3467:
3464:
3462:
3459:
3457:
3453:
3450:
3448:
3445:
3443:
3440:
3438:
3435:
3433:
3430:
3429:
3427:
3423:
3420:
3418:
3414:
3404:
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3399:
3396:
3395:
3393:
3389:
3383:
3380:
3379:
3377:
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3367:
3364:
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3359:
3357:
3354:
3353:
3351:
3347:
3344:
3342:
3338:
3334:
3327:
3322:
3320:
3315:
3313:
3308:
3307:
3304:
3291:
3287:
3286:
3282:
3280:
3276:
3275:
3271:
3269:
3266:
3262:
3261:
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1518:"Acromegaly"
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1500:. Retrieved
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1488:"Acromegaly"
1441:. Retrieved
1434:
1431:"acromegaly"
1425:
1417:the original
1405:
1402:"acromegaly"
1396:
1289:
1283:
1273:
1263:
1244:, Brazilian
1236:Tony Robbins
1166:Time Bandits
1164:
1158:
1149:Sultan Kösen
1141:
1138:Richard Kiel
1130:
1121:Rondo Hatton
1113:
1104:Eddie Carmel
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1049:
1040:
1036:
1032:
1023:
1014:
998:
981:nasal cavity
977:
961:
933:
920:somatostatin
908:
905:
901:somatostatin
890:
872:drug therapy
868:
843:radiotherapy
817:
793:
774:
767:
763:optic chiasm
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727:
709:
686:
683:Other tumors
672:
670:
658:
650:
648:production.
646:testosterone
638:menstruation
630:optic nerves
622:benign tumor
619:
604:optic chiasm
598:Hypogonadism
560:Hypertension
509:macroglossia
466:
438:malocclusion
359:
334:
301:benign tumor
294:
252:
251:
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3249:MedlinePlus
3111:âč The
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1127:Irwin Keyes
1110:Ted Cassidy
968:pegvisomant
944:cabergoline
882:Medications
783:(FSH, LH),
666:cell growth
584:Sleep apnea
505:prognathism
485:vocal cords
478:Soft tissue
430:prognathism
281:sleep apnea
162:Usual onset
151:sleep apnea
3538:Categories
3356:Acromegaly
3279:Acromegaly
3274:Patient UK
3225:DiseasesDB
3128:Acromegaly
2964:The Lancet
2745:Oliver G.
2726:Harish A.
2711:29 January
2447:: 540398.
2243:A201087184
1443:20 January
1388:References
1340:Tim Burton
1275:Twin Peaks
1230:impresario
1196: 173
1006:meningitis
912:gallstones
897:lanreotide
893:octreotide
804:gadolinium
492:fontanelle
454:Brow ridge
426:Mandibular
265:joint pain
253:Acromegaly
218:Medication
165:Middle age
34:Acromegaly
3480:Posterior
3375:Posterior
3260:eMedicine
3092:16 August
3066:16 August
2925:USA Today
2774:Pituitary
2411:0918-8959
1914:260166366
1753:Pituitary
1502:20 August
1348:Wack Pack
1270:The Giant
1246:kickboxer
1223:Argentine
1217:(Leonel)
1046:Prognosis
948:prolactin
829:Treatment
823:minoxidil
789:prolactin
715:Diagnosis
642:impotence
529:Skin tags
472:Headaches
434:maxillary
331:Treatment
325:gigantism
309:inherited
269:headaches
243:Frequency
234:Prognosis
203:Treatment
120:Specialty
3425:Anterior
3349:Anterior
3285:Orphanet
3268:derm/593
3140:Archived
3113:template
3043:17066567
2994:38097951
2986:28561004
2847:34782106
2839:18372348
2804:18597174
2679:Archived
2661:Archived
2638:Archived
2589:Archived
2566:29590449
2524:30050156
2473:22518126
2419:30078825
2362:Archived
2319:21724541
2297:Hormones
2278:12789195
2235:18846753
2208:24517150
2159:22564667
2103:31855373
2066:31855373
1973:24551163
1933:PLOS ONE
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1870:21464140
1821:18228147
1783:22903574
1692:22801883
1684:16887764
1649:Archived
1618:Archived
1587:Archived
1553:Archived
1496:Archived
1371:See also
1344:Big Fish
1304:Big Show
1280:Mr. Homn
1208:PĂo Pico
1098:sideshow
1069:comedies
1065:B-movies
985:nostrils
916:diabetes
857:, while
693:pancreas
662:mutation
634:hormones
132:Symptoms
3492:General
3391:General
3219:D000172
3115:below (
3034:1592053
2876:5 March
2866:Playboy
2795:2807602
2685:26 July
2657:Variety
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2515:7136157
2464:3296170
2368:24 July
2342:27 June
2199:4037730
2150:3791436
2108:27 June
2071:27 June
2014:9709926
1964:3925168
1941:Bibcode
1829:1365262
1774:3730092
1073:horrors
1004:leaks,
974:Surgery
924:insulin
839:Surgery
779:(TSH),
744:glucose
724:levels.
691:of the
654:sinuses
626:adenoma
337:surgery
313:glucose
207:Surgery
3265:med/27
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689:tumors
611:Causes
283:, and
271:, and
170:Causes
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3197:253.0
3183:inusl
3181:E22.0
2990:S2CID
2843:S2CID
1910:S2CID
1825:S2CID
1688:S2CID
1492:NIDDK
1342:film
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987:with
952:IGF-1
757:of a
697:lungs
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368:áŒÎșÏÎżÎœ
363:Greek
3214:MeSH
3203:OMIM
3192:9-CM
3094:2024
3068:2024
3039:PMID
2982:PMID
2878:2015
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2800:PMID
2713:2014
2687:2010
2615:2019
2562:PMID
2520:PMID
2469:PMID
2445:2012
2415:PMID
2407:ISSN
2370:2019
2344:2021
2315:PMID
2274:PMID
2239:Gale
2231:PMID
2204:PMID
2155:PMID
2110:2021
2099:PMID
2073:2021
2062:PMID
2033:ISBN
2010:PMID
1969:PMID
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1866:PMID
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1779:PMID
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1543:ISBN
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1248:and
1160:Zulu
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705:GHRH
673:GNAS
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389:mega
382:ÎŒÎγα
3290:963
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3172:ICD
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