Gigantism and Acromegaly

Jan van Eyck
1390, Maaseik – July 19, 1441, Bruges, Belgium

♦ Panel depicting the hermits and pilgrims / The Adoration of the Mystic Lamb ♦

The man in this painting is a giant. He is at least one-third larger than the others.
He is Saint Christopher, who, according to legend, carried pilgrims, including Christ, across the river.

♦ Diagnosis
Important features: large man, giant. Left foot is deformed (clubfoot or equino varus) and his big toe is crooked (hallux valgus).
Side effects: man
Clinical diagnosis: gigantism, acromegaly, secondary osteoarthritis.

♦ Definition: gigantism and acromegaly
There are two types of giantism: gigantism and acromegaly.
Gigantism occurs during adolescence when there is excessive production (hypersecretion) of growth hormones in the period before the ends of the long bones have grown together.
Acromegaly, if hypersecretion occurs only after bone growth has ceased
If it begins during adolescence and continues into adulthood, gigantism and acromegaly can occur together.

♦ Discussion
The characteristic feature of acromegaly is the increase in size of the bones and soft tissue of the hands, feet, the ridges of the eye sockets, the sinuses, and the lower jaw.
The skin becomes thick and rough. The subcutaneous tissue increases in thickness, which is often most easily seen on the tongue, lips, and ears. Internal organs such as the heart, thyroid, and liver also increase in size. Carbohydrate tolerance decreases, and about half of untreated patients have sugar in their urine (glycosuria).

If the disease progresses, the patient often develops osteoarthritis, a degeneration of the cartilage. Kyphosis and muscle weakness may also occur. High blood pressure is a common complication. Mental work becomes more difficult. The patient often becomes irritable and complains of persistent headaches.
Some of these symptoms are due to poor pituitary function caused by pressure from the pituitary tumor.
The disease usually progresses slowly. On the other hand, in many patients who have certain symptoms of acromegaly, the disease appears to have come to a standstill.

Source: Jan Dequeker

Jan Dequeker
The artist and the doctor look at paintings

Photos
Wikipedia