International Acromegaly Awareness Day | Do people become "uglier" as they age? Swollen hands and feet, high blood pressure may be the reason...

As people age, they may notice that their cheekbones become higher, their nasolabial folds deepen, and they wear larger shoes. These symptoms are not necessarily due to “aging” but may also be one of the rare diseases that is easily misdiagnosed: acromegaly.

"This disease is mostly diagnosed in middle-aged and elderly people, and often the patient has been suffering from the disease for more than ten years by the time the diagnosis is confirmed." The doctor said that acromegaly has a hidden onset and few acute symptoms in the early stage, and is often ignored by patients.

Shoe size increases, people become "uglier", and blood pressure is high. What other symptoms does acromegaly have?

"We had a case some time ago where the patient felt she had become 'uglier', with high cheekbones, deep nasolabial folds, and her shoe sizes getting bigger and bigger, almost to size 40, but she thought she was just old." Sun Min, chief physician of the Endocrinology Department of Jiangsu Provincial People's Hospital, said that the early symptoms of acromegaly are not obvious, and relevant examinations are often not done until complications become serious or a pituitary tumor is discovered during a physical examination.

"The course of acromegaly is relatively long, because its changes are very slow and difficult for patients to detect." Dr. Sun said that facial changes and enlarged hands and feet are relatively common manifestations. "Adults' shoe sizes are relatively stable, but patients with this disease may gradually increase their shoe sizes by 1 to 3 sizes."

In addition, symptoms of acromegaly include prominent cheekbones, thick lips, enlarged nose wings, rough skin, and even uncontrollable hypertension, diabetes, and decreased vision. When most of the symptoms appear at the same time, you need to consider the possibility of acromegaly and go to the hospital for screening in time.

The “culprit” is pituitary tumor. Most of them are benign. Can we just “ignore it”?

So, what is the cause of acromegaly? "Most of the time, the cause is a problem with the pituitary gland, usually an excessive secretion of growth hormone by a pituitary tumor, which can lead to acromegaly." Dr. Sun said that this type of pituitary adenoma is mostly benign, but due to the excessive secretion of growth hormone, it will bring a series of negative effects to the human body, and we cannot ignore it just because we hear it is "benign".

"We have a patient who was diagnosed with acromegaly a few years ago, but he thought it would not affect his life and was afraid of surgery, so he never came for intervention. Some time ago, his thyroid gland was enlarged due to acromegaly, which compressed his trachea and seriously affected his breathing quality, so he came for treatment. During the examination, it was found that the airway had been compressed to only 4 mm, which was already quite dangerous."

In fact, acromegaly brings more than just changes in appearance. The excessive secretion of growth hormone can also cause myocardial hypertrophy, articular cartilage hyperplasia, intestinal polyp hyperplasia, etc., leading to multiple joint pains, hypertension, heart disease and even colorectal cancer and other malignant tumors. At the same time, adenomas may also compress nerves and affect the patient's vision, so early intervention and treatment are needed.

**Can I recover after intervention treatment? ** What else should I pay attention to?

According to reports, the most important and effective way to treat acromegaly is surgery. "If the patient cannot tolerate the surgery or the hormone level is still elevated after surgery, we will use drugs and radiotherapy. The drugs can be used for life or for a short period of time. Some patients even suffer from heart failure or hypoxia due to high growth hormone before surgery. We will use drugs first to improve the safety and success rate of the surgery."

"After treatment, because the hormone levels have dropped, the appearance of most patients will be restored to a certain extent, and their blood pressure and blood sugar will also improve; but like chronic diseases such as hypertension, some patients will still need long-term medication after treatment." Director Sun especially reminded everyone that for chronic diseases, they must follow the doctor's advice, follow up regularly, and monitor and treat changes in physiological functions in a timely manner.

It was further learned that in the past, drugs for rare diseases were often very expensive. For example, a somatostatin receptor drug for acromegaly used to cost more than 10,000 yuan per injection. Now, after being included in medical insurance, treatment is carried out about once every six weeks, and the patient pays about 1,000 yuan out of pocket. With the National Health Commission and other six departments jointly issuing the "Second Batch of Rare Diseases Catalogue", which includes acromegaly, it is possible that the burden on patients will be further reduced in the future, creating better conditions for the long-term treatment of patients with rare diseases.