Increased growth hormone following puberty after epiphyseal plate closure .

Benign pituitary adenoma (95%), Excess growth hormone releasing hormone, tumours releasing growth hormone.

Prognathism, frontal bossing, enlarged nose, deep voice, macroglossia, coarse skin texture, enlargement of hands and feet, nerve entrapment, multiple skin tags, goitre

General change in appearance, excess sweating, headaches, visual changes, change in shoe/ring size, joint pains, sleep apnoea, symptoms of diabetes

Bloods: Fasting growth hormone and IGF-1 levels, glucose, U&E, lipid profile, 

pituitary profile

Oral Glucose Tolerance Test: No suppression of growth hormone in response 

to glucose load

Imaging: MRI pituitary

ECG:  To assess for cardiac abnormalities

Special Tests: Skin thickness, photographs from the past, cancer screen 

Medical: Somatostatin analogues – inhibit growth hormone release, growth 

hormone receptor antagonists or dopamine agonists

Surgical: Trans-sphenoidal surgery 

90% cured by surgery. If left untreated mortality rate is double the rate for the 

general population.