Acromegaly

Two new posts in one day???  I am on a roll...

This is my friend (and patient) Agnes.  

She has a condition called "acromegaly" or "gigantism."  That is one of those things that I learned about in med school but never saw in America.  Basically her pituitary gland in her brain is malfunctioning, producing too much growth hormone.  Agnes has quite a few of the classic features and symptoms.  She has an enlarged jaw.  Her facial features are course, her forehead and nose enlarged.  Her hands and feet have also grown.  She has chronic headaches, symptoms of carpal tunnel syndrome, and amenorrhea.

 Acromegaly is usually caused by a tumor of the pituitary gland.  A CT scan would confirm the etiology.  A relatively simple surgery could potentially cure her.  Well, the only CT scan in PNG is in the capital city of Port Moresby.  And that is where the neurosurgeon also resides.  Agnes's family has been saving for a plane ticket but they haven't been able to afford the trip quite yet.

In the mean time, I am doing my best to take care of her medically.  I started her on bromocriptine and OCPs.  A TSH showed that she also has hypothyroid, so she is on levothyroxine as well.  She stopped by this past week on the way to get a follow up blood test.  And she was very excited that some of her symptoms have improved!  Hopefully someday she will be able to make it to POM and get definitive treatment.  Until then, I sure enjoy seeing my friend in clinic :).

That's all, folks!