2. GROWTH HORMONE
-Growth hormone is secreted by the somatotrophs of the
anterior pituitary.
-It is essential for linear growth.
-It acts by producing a group of hormones called
somatomedins.
-The prime somatomedin, Somatomedin-C is synthesised in
the liver and in bone.
-Hypothalamic secretion of growth hormone releasing
hormone (GHRH) stimulates GH secretion and
Somatostatin inhibits it.
-Other neurotransmitters are also known to influence GH
secretion (Dopamine stimulates GH secretion by
stimulating GRH).

3. WHAT IS ACROMEGALY?
-It is a condition which results from excess secretion of growth
hormone from Anterior Pituitary in adults after fusion of the
epiphysis.
-A pituitary adenoma is usually the cause.
-They are usually classified by size and function.
•Microadenomas are <10 mm in diameter and cause clinical
manifestations only if they produce excess hormone.
-Usually they are too small to produce mass effects. Nonsecretory
microadenoma is common.
•Macroadenomas are >10 mm in diameter and may produce any
combination of pituitary hormone excess.
- Pituitary tumours often reach the size of macroadenomas by the
time the diagnosis is made.
-In rare cases ,GH excess is also caused by ectopic secretion of
GH by carcinoid tumours and pancreatic islet cell tumours.

4. PITUITARY ADENOMA

5. ACROMEGALY-SIGNS AND SYMPTOMS

6. MANIFESTATIONS OF ACROMEGALY

7. CLINICAL AND ROENTGENOGRAPHIC FEATURES