Majority, if not all,
of us who have made it into adulthood, have gone through puberty.
For the past seven
years of my life, I’ve learnt and experienced that rapid growth occurs during
puberty. Like all natural processes in the body, growth is of great importance
since it prepares the body for reproduction, efficient cell replacement and the
strain of adulthood. Seeing that growth is important, we measure it through
height and dry mass.
At a recent group
meeting, I heard a huge bass voice. That’s a frightening voice I thought. I
started looking for the source of that voice until I came across a giant kid……do
6 ft. kids even exist? The kid continued
talking to a lady next to him. Somehow, the
conversation took a turn for the worst. He started crying to the point where
his words became confusing and all I heard were “can’t stop growing”, “maybe
it’s normal even though the normal is 4.8 ft.”, “I grew 8 inches in a year” and
“I’m 12 and my parents are 5.7 ft.” The
kid believed that his growth was normal but it wasn’t.
As mentioned before,
height is used to measure growth, but that kid’s height as well as growth rate
wasn’t normal. By medical
standards, he was taller than 99.9% of the children his age. An abnormal and
rapid increase in height that occurs before adulthood is usually due to a non cancerous tumor
which affects the endocrine system’s pituitary gland. This condition is known
as gigantism.
During gigantism, the tumor cells in the anterior pituitary lobe produce more Growth Hormone (GH) than normal. As a result, the release of
hypothalamic Growth Hormone Inhibiting Hormone (GHIH) and Growth Hormone
Releasing Hormone (GHRH) can no longer balance GH levels so protein synthesis
and the use of fat for fuel also become abnormally high. In addition to this, the
liver and other tissues are stimulated to release Insulin-like Growth Factors
(IGFs) at much higher rates. Simply put, growth occurs everywhere (skeletal muscles, bones etc.) and highly manifests
itself as rapid upward growth in children, because of their long bones’ unsealed
epiphyseal growth plates. Besides rapid upward growth, other signs of gigantism include:
- Large hands and feet
- A prominent jaw and forehead
- Weakness and headaches
Picture of Pituitary Gland
Picture of Growth Hormone's Effects
Picture of an Immature and Mature Growth Plate
The body of a person
suffering from gigantism doesn’t get a chance to adapt to the growth. Untreated
gigantism can result in health problems such as stroke, nerve damage, weak
muscles etc., so medical intervention is always needed.
Zooming in on the
kid! I rushed to him in order to say that he should see a doctor. If the doctor
thinks the same as I do, he/she would recommend:
- Blood testing: In this test, GH and Insulin-like Growth Factor-I (IGF-I) levels are measured. If GH levels are above normal compared to that of the usual amount for age, (more than 0-20 ng/mL or 0-904 pmol/L for 12 yr olds), gigantism is suspected. Increased IGH-I levels also indicate gigantism.
- Oral Glucose Tolerance Test (OGTT): In this test, a person is given 75 grams of glucose solution. If blood GH levels remain the same or do not drop to less than 1 ng/ml, GH levels are too high.
- Magnetic Resonance Imaging (MRI): In this test, a scan uses magnetic waves to create images of the pituitary gland. If a dense, whitish and abnormal mass is found within the pituitary gland's region, a tumor is present.
If each test, especially the MRI comes out positive for gigantism, the doctor would treat the pituitary tumor
by surgical removal, radiation therapy and/or medicines - specifically Somatostatin analogues which suppress GH secretion. Medicines are used when other forms of treatment risk the patient's life or gigantism occurs without a tumor. Shockingly, the 12 yr. old child might
still grow more after treatment!!!!!
Picture Showing Methods of Treating Gigantism
Remember, too much of anything has always been bad. If you notice
abnormal growth in a child, you should advise the child to seek medical attention. To read more
about gigantism, click here
and then click here.
