GIGANTISM
GIGANTISM: Excerpt from Differential Diagnosis in Primary Care
The differential of this symptom can be developed physiologically by
overactivity or underactivity of an endocrine gland. Thus, overactivity of
the pituitary gland (as in eosinophilic adenomas of the pituitary) causes
gigantism from too much growth hormone, whereas underactivity of the
testicles (as in Klinefelter syndrome) produces a tall individual because
the inadequate secretion of testosterone delays closure of the epiphysis.
Tumors of the adrenal cortex, testicle, and pineal gland may produce
macrogenitosomia or prepubertal gigantism by stimulation of overgrowth by
androgens and estrogens only to lead to ultimate dwarfism by premature
closure of the epiphysis. Primary gigantism is like the gigantism of plants
and flowers; genetic arachnodactyly is also a genetic form of gigantism,
although it is a true disease and is associated with dislocation of the
lens.
Approach to the Diagnosis
The approach to the diagnosis of these conditions is simple.
Radioimmunoassay (RIA) studies of hormone levels are now readily available, and
x-rays of the skull with CT scans and tomography will allow a diagnosis.
Referral to an endocrinologist may be wise from the start, especially
because potentially tall girls may want endocrine therapy to close the
epiphysis early.
Other Useful Tests
-
Serum growth hormone (pituitary adenoma)
- Serum corticotropin, luteinizing hormone (LH), and
follicle-stimulating hormone (FSH) levels (pituitary adenoma)
- Serum testosterone (Klinefelter syndrome, adrenal tumors, and
hyperplasia)
- Serum dihydrotestosterone and dehydroepiandosterone sulfate
(adrenal tumor and hyperplasia)
- Urine hydroxyproline level (Marfan syndrome)
- Urine homocystine level (homocystinuria)
- Chromosomal analysis (Klinefelter syndrome)
- MRI of the pituitary (microadenoma)
- Testicular biopsy (Klinefelter syndrome)
Pictures
Book Source Details
- Book Title: Differential Diagnosis in Primary Care
- Author(s): R. Douglas Collins MD, FACP
- Year of Publication: 2007
- Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.
More About Soto's Syndrome
More Medical Textbooks Online about Soto's Syndrome
Review other book chapters online related to Soto's Syndrome:
Medical Books Excerpts
- GIGANTISM
- "Algorithmic Diagnosis of Symptoms and Signs" (2003)
- [ read ]
- GIGANTISM
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
- GIGANTISM
- "Differential Diagnosis in Primary Care" (2007)
- [ read ]
Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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