Tumor: What Is Gigantism?
Tumor: What Is Gigantism?
Tumor: What Is Gigantism?
What is Gigantism?
temperature control
sexual development
growth
metabolism
urine production
When a tumor grows on the pituitary gland, the gland makes far more growth
hormone than the body needs.
If your child has gigantism, you may notice that they’re much larger than
other children of the same age. Also, some parts of their body may be larger
in proportion to other parts. Common symptoms include:
excessive sweating
severe or recurrent headaches
weakness
insomnia and other sleep disorders
delayed puberty in both boys and girls
irregular menstrual periods in girls
deafness
How is Gigantism diagnosed?
In a normal body, growth hormone levels will drop after eating or drinking
glucose. If your child’s levels remain the same, it means their body is producing too
much growth hormone.
If the blood tests indicate gigantism, your child will need an MRI scan of the
pituitary gland. Doctors use this scan to find the tumor and see its size and position.
Treatments for gigantism aim to stop or slow your child’s production of growth
hormones.
Surgery
Removing the tumor is the preferred treatment for gigantism if it’s the underlying cause.
The surgeon will reach the tumor by making an incision in your child’s nose.
Microscopes or small cameras may be used to help the surgeon see the tumor in the
gland. In most cases, your child should be able to return home from the hospital the day
after the surgery.
Medication
In some cases, surgery may not be an option. For example, if there’s a high risk
of injury to a critical blood vessel or nerve. Your child’s doctor may recommend
medication if surgery is not an option. This treatment is meant to either shrink the tumor
or stop the production of excess growth hormone.
Your doctor may use the drugs octreotide or lanreotide to prevent the growth
hormone’s release. These drugs mimic another hormone that stops growth hormone
production. They’re usually given as an injection about once a month.
In situations where these drugs are not helpful, daily shots of pegvisomant
might be used as well. Pegvisomant is a drug that blocks the effects of growth
hormones. This lowers the levels of IGF-1 in your child’s body.
Gamma knife treatment takes months to years to be fully effective and to return
the levels of growth hormone to normal. It’s performed on an outpatient basis
under general anesthetic.
DWARFISM
What is Dwarfism?
The term “short stature” is often preferred over “dwarfism” or “dwarf.” The term
“little person” or “little people” is often used, too. One of the largest advocacy groups for
people with dwarfism is the Little People of America (LPA). “Midget” isn’t an acceptable
label. Be mindful of the words or label a person with dwarfism uses to describe
themselves. Also be sensitive to the challenges or prejudice they may face in everyday
life.
Types of Dwarfism
Though there are many different causes of dwarfism, there are two main types
of the condition: proportionate and disproportionate.
Proportionate Dwarfism
When the head, trunk, and limbs are all proportionate to each other, but much
smaller than those of an average-sized person, the condition is known as proportionate
dwarfism.
This type of dwarfism is often the result of a hormone deficiency. It can often be
treated with hormone injections while a child is still growing. As a result, someone born
with proportionate dwarfism may be able to reach an average height or get close to it.
Disproportionate dwarfism
Achondroplasia
Turner syndrome
Hypothyroidism
Dwarfism is usually the result of a genetic mutation. But having a gene or genes
responsible for dwarfism can occur in a couple of ways.
In some cases, it can happen spontaneously. You may not be born with mutated
genes inherited from a parent. Instead, a mutation of your genes happens on its own
usually without a cause doctors can discover.
Inherited genetic disorders can take two forms. One is recessive, which means
you inherit two mutated genes (one from each parent) to have the condition. The other
is dominant. You only need one mutated gene from either parent to have the disorder.
Making a tentative prenatal diagnosis while the baby is still in the womb can be
done with an ultrasound. If the baby’s appearance suggests dwarfism, or if the parents
know they carry a gene for dwarfism, a doctor may recommend amniocentesis. This is a
lab test of amniotic fluid from the womb.
Genetic testing may be helpful in some cases. This is particularly true when
distinguishing one potential cause of dwarfism from another. A blood test to check for
growth hormone levels may also help confirm a diagnosis of dwarfism caused by
hormone deficiency.
Possible Complications
bowed legs
arthritis
progressive hunching of the back
narrowed channel in the lower spine, resulting in pressure on the spinal cord
(spinal stenosis)
spinal pressure at the base of the skull
excess brain fluid (hydrocephalus
sleep apnea
delays in motor skills development as a baby
weight gain that can place more strain on the spine and joints
Pregnancy in those with dwarfism can present its own set of potential complications,
including respiratory problems. A cesarean delivery is usually necessary, because the
size of the pelvic region won’t allow for a vaginal delivery.
For some people with proportionate dwarfism, poor development of the organs can
lead to significant health problems.
Condition Management
For people with growth hormone deficiency, injections of synthetic human growth
hormone may be helpful. Children receiving this treatment don’t always reach an
average height, but they can get close.
The treatment includes daily injections when a child is young, though injections
may continue into a person’s 20s. This may be done if there are concerns about full
adult maturation and sufficient muscle and fat.
Surgical options
For others with dwarfism, surgical treatments may be necessary and helpful to
living a longer, healthier life.
Another surgical procedure for people with excess fluid around the brain is to
place a type of tube, called a shunt, in the brain. This can relieve some of that fluid and
reduce pressure on the brain.
Physical Therapy and Orthotics
Orthotics are custom-made devices that fit into your shoes to help improve your
foot health and function. If dwarfism is affecting your balance, how you walk, or other
aspects of foot function, talk with a podiatrist about how orthotics may help you.
Is Dwarfism Hereditary?
If you have achondroplasia, for example, you have one dwarfism gene and one
unaffected gene. This means when both parents have achondroplasia, there is a 25
percent chance their child will inherit the unaffected gene and grow to at least an
average height.
There is a 50 percent chance of the child inheriting one of each type of gene, but
a 25 percent chance that the baby will have two dwarfism genes. Babies born with what
is called a “double-dominant syndrome” often die at birth or soon afterward.
CRETINISM
Symptoms
Causes
Iodine deficiency is no longer considered a health risk in the United States due to
the introduction of iodized salt. However, it’s still the most common preventable
cause of impaired neurological function in the world. Because our bodies don’t make
iodine, we need to get it from food. Iodine gets into food through soil. In some parts of
the world, the soil is lacking in iodine.
Treatment options
Newborns are routinely screened for thyroid hormone levels. The test involves
taking a small blood sample from the baby’s heel. A laboratory checks the baby’s blood
levels of thyroid hormone (T4) and thyroid-stimulating hormone (TSH).
Doctors called pediatric endocrinologists treat congenital hypothyroidism. The
main treatment is to give the baby thyroid hormone (levothyroxine). This condition must
be treated within the first four weeks after birth or the intellectual disability may be
permanent. Thyroid hormone comes in a pill that parents can crush up into their baby’s
breast milk, formula, or water. Parents need to be cautious about using some formulas.
Soy protein and concentrated iron formulas can interfere with the absorption of thyroid
hormone.
Once babies are on thyroid hormone medication, they will need to have blood
tests every few months. These tests will check that their TSH and T4 levels are within a
normal range.
Prevention
Children who are born with a severely underactive thyroid gland can develop
intellectual disability if the condition isn’t treated quickly. A child’s IQ can drop several
points for every few months that treatment is delayed. Growth and bone strength can
also be affected.
an abnormal walk
muscle spasticity
an inability to speak (mutism)
autistic behavior
vision and hearing problems
problems with memory and attention
Diabetes insipidus is a rare condition that causes your body to make a lot
of urine that is "insipid," or colorless and odorless. Most people pee out 1 to 2 quarts a day.
People with diabetes insipidus can pass between 3 and 20 quarts a day. It's also called
central DI, pituitary DI, hypothalamic DI, neurohypophyseal DI, or neurogenic DI.
Symptoms include:
Severe thirst
Peeing more than 3 liters a day
Getting up to go a lot at night
Peeing during sleep (bed-wetting)
Pale, colorless urine
Low measured concentration of urine
Preference for cold drinks
Dehydration
Weakness
Muscle pains
Crankiness
Extreme thirst: often drinking more than 1 gallon of liquid per day
Fatigue
Feeling sluggish
Dizziness
Confusion
Nausea
Loss of consciousness
Symptoms in Infants and Children
Many of the symptoms are similar in younger people. In infants, watch for:
Crankiness
Slow growth
Poor feeding
Weight loss
Fever
Vomiting
When you’re thirsty or a little dehydrated, your vasopressin levels go up. Your
kidneys absorb more water and put out concentrated urine. If you’ve had enough to
drink, vasopressin levels fall, and what comes out is clear and diluted.
Changes in the genes that you inherit from your parents can make you more
likely to get diabetes insipidus. This happens in 1% to 2% of cases.
You get this when damage to your hypothalamus or pituitary gland affects
how your body makes or puts out vasopressin. Your kidneys remove too much
fluid from your body, and you pee more. This damage can result from:
A tumor
A head injury
Infection
Inflammation
Surgery
You get this when your kidneys don’t respond to vasopressin and take too
much fluid from your bloodstream. Doctors don’t always know why it happens,
but some causes include:
Chronic kidney disease
This type, also known as primary polydipsia, happens when your body has
trouble controlling thirst. When you drink, the liquid lowers the amount of
vasopressin that your body makes, while making you pee more. Causes include
damage to your hypothalamus or pituitary glands from:
A tumor
A head injury
Infection
Inflammation
Surgery
Some medications or mental health problems could make you more likely to get
dipsogenic diabetes insipidus.
Gestational Diabetes Insipidus.
Your doctor will do a physical exam. A checkup may not show any signs of
central DI, except maybe an enlarged bladder or symptoms of dehydration.
They’ll ask questions about your health history, including your family’s health.
You might get a series of tests that include:
Urinalysis
You’ll give a sample of your pee, and your doctor will send it to a lab to
see whether it’s dilute or concentrated. They can also check for glucose, which
can help them decide if you have diabetes insipidus or diabetes mellitus. You
might need to collect your pee over a 24-hour period to see how much you’re
putting out.
Blood test
This will measure the electrolytes and glucose in your blood. This lets your
doctor know if you have diabetes mellitus or diabetes insipidus. It may help them
figure out which type.
This measures the changes in your body weight, blood sodium, and urine
concentration after you don’t drink anything for a while. There are two types:
You stop drinking for a short time. You collect a sample and take it
back to your doctor, who sends it to a lab.
You’ll have this done in a hospital so doctors can make sure you
don’t get dehydrated. You’ll be weighed and give a sample every hour or
two until:
MRI
This test takes detailed pictures of your internal organs and soft tissues.
The doctor uses it to see if there’s a problem with your hypothalamus or pituitary
gland.
Genetic screening
Your doctor may suggest this test if your family members have had
problems with making too much urine.
Complications of Diabetes Insipidus
Diabetes insipidus that isn’t under control can make you more likely to have
complications like:
Dehydration.
Diabetes insipidus makes it hard for your body to hold on to water. It’s
easy to get dehydrated.
Electrolyte imbalance.
A headache
Irritability
Muscle pain
Less sleep.
First, your doctor will tell you to drink plenty of fluids. That will replace the
constant loss of water. Other treatments depend on which type you have: