Gigantism and Dwarfism

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What drugs or treatments are available to help correct conditions of gigantism and dwarfism and how do they work?

When the pituitary gland overproduces the growth hormone a rare disorder known as Acromegaly or gigantism may develop. The overproduction of the growth hormone most of the time is caused by a tumor. Swelling and thickening of the skin, growth and enlargement of the bones, especially if the hands, feet and face are caused by excess growth hormone.

Acromegaly or gigantism is a rare hormonal disorder than can develop when your pituitary gland overproduces the growth hormone. Most of the time this overproduction of the growth hormone is caused by a tumor. The excess growth hormone causes swelling, thickening of the skin, tissue growth and enlargement of the bones, especially in the hands, feet and face.

The overproduction of the growth hormone in children can lead to a condition known as gigantism. This may lead to an abnormal increase in the height and bone growth. Overproduction of the growth hormone in middle aged adults causes acromegaly.

The treatment of choice in pituitary tumors is surgery. When surgery cannot be performed or if the entire tumor cannot be removed, then the treatment of choice is medications.

Somatostatin analogues (SSA) are synthetic versions of the hormone in the brain somatostatin. Two SSA's are octreotide (Sandostatin, Sandostatin LAR) and lanreotide (Somatuline Depot). Somatostatin is a hormone that inhibits the release of the growth hormone. SSA's can decrease the growth hormone levels by blocking the excess production in the pituitary gland. Common side effects are pain at the injection site, intestinal cramping, diarrhea and gallbladder problems.

Growth hormone receptor antagonists (GHRAs). The medication pegvisomant (Somavert) blocks the effect of growth hormone on the body tissues. It is administered daily by a subcutaneous injection. This medication can normalize growth hormone levels and relieve symptoms in most people affected by acromegaly. Some common side effects are headache, nausea, diarrhea and fatigue.

Dopamine agonists such as Cabergoline (Dostinex) and bromocroptine (Parlodel) are given to reduce production of the growth hormone and to shrink tumors. Both of these medications can be taken orally in pill form. They are not as effective as the SSA's and GHRA's. Sometimes doctors will prescribe a combination of Dopamine agonists with somatostatin analogues for treatment. Side effects that are common include headache, nausea and intestinal cramping. Pegvisomant has been used to treat acromegaly, or gigantism. It is a form of a growth hormone antagonist known as B2036. This growth hormone has increased disposition in one binding site and a lowered disposition in the second binding site. It has been shown that this molecule still enables reaction of the growth hormone receptor at the cell surface, but does not allow the necessary conformational changes.

A growth hormone deficiency may result in a condition known as dwarfism. Dwarfism can be defined as a short height, that is the result of a genetic or medical condition. Adults with dwarfism are usually less than four feet ten inches tall.

Treatments for conditions relating to dwarfism do not increase height, but may lessen complications.

Surgery is one treatment option for dwarfism. Some of the common procedures that are done surgically are to insert metal staples into the ends of long bones into the growth plate in order to correct the direction that the bones are growing. They can divide a limb bone, straighten it and insert a metal plate to hold it in place. They may insert rods or staples to correct the shape of the spine. They may increase the size of the opening in the vertebrae to alleviate pressure on the spinal cord.

Lengthening of the limbs is a treatment choice of people with dwarfism. During this procedure, the surgeon divides a long bone into two or more...
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