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Acromegaly and pituitary gigantism

ICD10CM code

Name of the Condition

  • Acromegaly and Pituitary Gigantism

Summary

Acromegaly and pituitary gigantism are conditions characterized by excessive growth hormone production, leading to abnormal enlargement of bones and tissues. Acromegaly typically occurs in adults, while pituitary gigantism occurs in children.

Causes

These conditions are generally caused by a benign tumor on the pituitary gland, known as a pituitary adenoma, which results in overproduction of growth hormone.

Risk Factors

  • Family history of pituitary tumors.
  • Rare genetic syndromes, such as Multiple Endocrine Neoplasia Type 1 (MEN1).
  • Age (pituitary gigantism occurs in children and adolescents, while acromegaly typically presents in adults).

Symptoms

  • Enlarged hands and feet.
  • Coarsened facial features.
  • Joint pain and limited mobility.
  • Thickened skin.
  • Enlarged organs, such as the heart.

Diagnosis

  • Blood tests measuring levels of growth hormone and Insulin-like Growth Factor 1 (IGF-1).
  • Oral glucose tolerance test to observe growth hormone suppression.
  • Magnetic Resonance Imaging (MRI) for pituitary gland visualization.

Treatment Options

  • Surgery: Removal of the pituitary tumor is often the first line of treatment.
  • Medications: Somatostatin analogs, dopamine agonists, and growth hormone receptor antagonists help reduce hormone levels or tumor size.
  • Radiation Therapy: Used if surgery and medication are not completely effective; aims to control tumor growth.

Prognosis and Follow-Up

  • The prognosis varies; early detection and treatment improve outcomes significantly.
  • Lifelong monitoring of hormone levels and regular imaging are crucial to manage recurrence or progression.

Complications

  • Cardiovascular issues, such as hypertension and heart disease.
  • Diabetes mellitus.
  • Sleep apnea.
  • Increased risk of certain cancers.

Lifestyle & Prevention

  • No definitive preventive measures due to its nature, but early diagnosis plays a crucial role in minimizing complications.
  • Regular medical check-ups and screenings if there's a family history of the condition.

When to Seek Professional Help

  • Persistent joint pain or changes in facial features.
  • Unexplained changes in shoe or ring size in adults.
  • Symptoms of vision changes, headaches, or rapid growth in children.

Additional Resources

Tips for Medical Coders

  • Ensure the distinction between acromegaly onset in adults and gigantism in children for accurate coding.
  • Avoid confusion with similar endocrine pathologies by confirming diagnosis details in patient records.
  • Double-check tumor details and related findings from diagnostic imaging and endocrinology tests.

Medical Policies and Guidelines for Acromegaly and pituitary gigantism

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