Acromegaly and Gigantism

Human growth hormone (GH), a single-chain peptide of 191 amino acids, was isolated from somatotroph cells of the anterior pituitary gland in 1956 and first used therapeutically for treatment of pituitary dwarfism in 1958 (Raben, 1958). Pituitary dwarfism is the classic form of growth hormone deficiency during childhood. Gigantism refers to any standing height more than 2 standard deviations above the mean for the person's sex, age, and Tanner stage. Abnormally high linear growth due to excessive action of insulin-like growth factor-I (IGFI)/GH causes gigantism while the epiphyseal growth plates are open during childhood, as puberty occurs it is followed by progressive acromegalic changes leading to a picture of a giant with acromegalic features acromegalic gigantism. When onset disease is after epiphyseal closure, only acromegaly results. Acromegaly, a somatic growth and proportion disorder first described by Marie in 1886 (Marie, 1886). Elevated levels of growth hormone and IGF-1 are the hallmarks of this syndrome (Melmed, et al., 1983). When Marie first desribed this syndrome at his patients, pitutiary overgrowth is the cause or reflection of the visceromegaly at these patients. İn 1909, Harvey Cushing reported the remission of clinical symptoms of acromegaly after partial hypophysectomy, thus indicating the etiology of the disease and its potential treatment as well (Cushing, 1909).