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Gigantism

March 08, 2023

Not to be confused with Deep-sea gigantism or Island gigantism.

Gigantism (Greek: γίγας, gígas, "giant", plural γίγαντες, gígantes), also known as giantism, is a condition characterized by excessive growth and height significantly above average. In humans, this condition is caused by over-production of growth hormone[2] in childhood, resulting in people up to 2.7 m (9.0 ft) in height.[3][4][5][6]

Gigantism
Other namesGiantism
Robert Wadlow stood 8 ft 11 in (2.72 m)
SpecialtyEndocrinology
SymptomsAbnormal growth in height or size, weakness and insomnia[1]
ComplicationsExcessive sweating, delayed puberty, weakness and severe or recurrent headaches, common stroke, vomiting, high fevers, sleepiness, dry mouth, diarrhea, stomachache, ear pain, memory loss, back pain
CausesHyperplasia in the pituitary gland
TreatmentSurgically remove the enlarged pituitary gland
MedicationOctreotide, lanreotide or pegvisomant

It is a rare disorder resulting from increased levels of growth hormone before the fusion of the growth plate which usually occurs at some point soon after puberty. This increase is most often due to abnormal tumor growths on the pituitary gland.[7][8] Gigantism should not be confused with acromegaly, the adult form of the disorder, characterized by somatic enlargement specifically in the extremities and face.[9][10]

Cause

Gigantism is characterized by an excess of growth hormone (GH). The excess of growth hormone that brings about gigantism is virtually always caused by pituitary growths (adenomas).[8] These adenomas are on the anterior pituitary gland. They can also cause overproduction of GH's hypothalamic precursor known as growth hormone releasing hormone (GHRH).[11]

As a result of the excessive amounts of growth hormone, children achieve heights that are well above normal ranges.[12] The specific age of onset for gigantism varies between patients and gender, but the common age that excessive growth symptoms start to appear has been found to be around 13 years.[7] Other health complications, such as hypertension, may occur in pediatric patients with hyper-secretion of growth hormone. Characteristics more similar to those seen in acromegaly may occur in patients that are closer in age to adolescence since they are nearing growth plate fusion.[13]

Hormonal cause

Growth hormone (GH) and insulin-like growth factor-I (IGF-I) are two substances that have been identified as influencing growth plate formation and bone growth and, therefore, gigantism. Their specific mechanisms are still not well understood.[7][14]

More broadly, GH and IGF have both been identified to be involved in most stages of growth: embryonic, prenatal, and postnatal.[15][16] Moreover, the receptor gene for IGF has been shown to be particularly influential throughout various stages of development, especially prenatally. This is the same for GH receptor genes which have been known to drive overall growth throughout various pathways.[15][17]

Growth hormone is a precursor (upstream) of IGF-I, but each has its independent role in hormonal pathways. Yet both seem to ultimately come together to have a joint effect on growth.[16]

Diagnostic testing

Evaluation of growth hormone hyper-secretion cannot be excluded with a single normal GH level due to diurnal variation. However, a random blood sample showing markedly elevated GH is adequate for diagnosis of GH hyper-secretion. Additionally, a high-normal GH level that fails to suppress with administration of glucose is also sufficient for a diagnosis of GH hyper-secretion.[18]

Insulin-like growth factor-1 (IGF-1) is an excellent test for evaluation of GH hyper-secretion. It does not undergo diurnal variation and will thus be consistently elevated in GH hyper-secretion and therefore patients with gigantism. A single normal IGF-1 value will reliably exclude GH hyper-secretion.[18]

Genetics

Finding a specific genetic cause for gigantism has proven to be difficult. Gigantism is the primary example of growth hormone hyper-secretion disorders, a group of illnesses that are not yet deeply understood.[7]

Some common mutations have been associated with gigantism. Pediatric gigantism patients have shown to have duplications of genes on a specific chromosome, Xq26. Typically, these patients also experienced an onset of typical gigantism symptoms before reaching the age of 5. This indicates a possible linkage between gene duplications and the gigantism.[19]

Additionally, DNA mutations in the aryl hydrocarbon receptor interacting protein (AIP) gene are common in gigantism patients. They have been found to be present in about 29 percent of patients with gigantism.[8] AIP is labeled as a tumor suppressor gene and a pituitary adenoma disposition gene.[8][20]

Mutations in AIP sequencing can have deleterious effects by inducing the development of pituitary adenomas which in turn can cause gigantism.[8][20]

Two specific mutations in the AIP gene have been identified as possible causes of pituitary adenomas. These mutations also have the ability to cause adenoma growth to occur early in life.[21] This is typical in gigantism.

Additionally, a large variety of other known genetic disorders have been found to influence the development of gigantism such as multiple endocrine neoplasia type 1 and 4, McCune-Albright syndrome, Carney complex, familial isolated pituitary adenoma, X-linked acrogigantism (X-LAG).[8][22]

Although various gene mutations have been associated with gigantism, over 50 percent of cases cannot be linked to genetic causes, showing the complex nature of the disorder.[7]

Treatment

Many treatments for gigantism receive criticism and are not accepted as ideal. Various treatments involving surgery and drugs have been used to treat gigantism.[23]

Pharmaceuticals

Pegvisomant is one pharmaceutical drug which has received attention for being a possible treatment route for gigantism. Reduction of the levels of IGF-I as a result of pegvisomant administration can be incredibly beneficial for the pediatric gigantism patients.[23]

After treatment with pegvisomant, high growth rates, a feature characteristic of gigantism, can be significantly decreased.[23] Pegvisomant has been seen to be a powerful alternative to other treatments such as somatostatin analogues, a common treatment method for acromegaly, if drug treatment is paired with radiation.[24]

Finding the optimal level of pegvisomant is important so normal body growth is not negatively affected. In order to do this, titration of the medication can be used as a way to find the proper administration level.[23]

See acromegaly for additional treatment possibilities.

Terminology

 
Daniel Cajanus (1704–1749), a Finnish giant
 
André the Giant, a wrestler and actor in The Princess Bride
 
Giantess Anna Swan with her parents

The term is typically applied to those whose height is not just in the upper 1% of the population but several standard deviations above mean for persons of the same sex, age, and ethnic ancestry. The term is seldom applied to those who are simply "tall" or "above average" whose heights appear to be the healthy result of normal genetics and nutrition. Gigantism is usually caused by a tumor on the pituitary gland of the brain. It causes growth of the hands, face, and feet.[25][better source needed] In some cases the condition can be passed on genetically through a mutated gene.[26]

Other names somewhat obsolete for this pathology are hypersoma (Greek: hyper over the normal level; soma body) and somatomegaly (Greek; soma body, genitive somatos of the body; megas, gen. megalou great). In the past, while many of them were social outcasts because of their height, some (usually unintentionally) found employment in Friedrich Wilhelm I's famous Potsdam Giants regiment.

Many of those who have been identified with gigantism have had multiple health problems involving the circulatory or skeletal system, as the strain of maintaining a large, heavy body places abnormal demands on both the bones and the heart.

See also

References

  1. ^ What causes gigantism?-healthline
  2. ^ "" at Dorland's Medical Dictionary
  3. ^ "Gigantism | UCLA Pituitary Tumor Program". pituitary.ucla.edu. Retrieved 27 April 2017.
  4. ^ "Gigantism: MedlinePlus Medical Encyclopedia". medlineplus.gov. Retrieved 27 April 2017.
  5. ^ "Gigantism and Acromegaly: Practice Essentials, Background, Pathophysiology and Etiology". 7 January 2017. {{cite journal}}: Cite journal requires |journal= (help)
  6. ^ "Gigantism and Acromegaly – Hormonal and Metabolic Disorders – MSD Manual Consumer Version". MSD Manual Consumer Version. Retrieved 27 April 2017.
  7. ^ a b c d e Rostomyan, Liliya; Daly, Adrian F.; Petrossians, Patrick; Nachev, Emil; Lila, Anurag R.; Lecoq, Anne-Lise; Lecumberri, Beatriz; Trivellin, Giampaolo; Salvatori, Roberto (October 2015). "Clinical and genetic characterization of pituitary gigantism: an international collaborative study in 208 patients". Endocrine-Related Cancer. 22 (5): 745–757. doi:10.1530/ERC-15-0320. ISSN 1479-6821. PMC 6533620. PMID 26187128.
  8. ^ a b c d e f Rostomyan, Liliya; Potorac, Iulia; Beckers, Pablo; Daly, Adrian F.; Beckers, Albert (2017). "AIP mutations and gigantism". Annales d'Endocrinologie. 78 (2): 123–130. doi:10.1016/j.ando.2017.04.012. PMID 28483363.
  9. ^ Chanson, Philippe; Salenave, Sylvie (25 June 2008). "Acromegaly". Orphanet Journal of Rare Diseases. 3: 17. doi:10.1186/1750-1172-3-17. ISSN 1750-1172. PMC 2459162. PMID 18578866.
  10. ^ Capatina, Cristina; Wass, John A. H. (August 2015). "60 YEARS OF NEUROENDOCRINOLOGY: Acromegaly". The Journal of Endocrinology. 226 (2): T141–160. doi:10.1530/JOE-15-0109. ISSN 1479-6805. PMID 26136383.
  11. ^ Zimmerman, D; Young, W F; Ebersold, M J; Scheithauer, B W; Kovacs, K; Horvath, E; Whitaker, M D; Eberhardt, N L; Downs, T R (1 January 1993). "Congenital gigantism due to growth hormone-releasing hormone excess and pituitary hyperplasia with adenomatous transformation". The Journal of Clinical Endocrinology & Metabolism. 76 (1): 216–222. doi:10.1210/jcem.76.1.8421089. ISSN 0021-972X. PMID 8421089.
  12. ^ Eugster, Erica A.; Pescovitz, Ora H. (1 December 1999). "Gigantism". The Journal of Clinical Endocrinology & Metabolism. 84 (12): 4379–4384. doi:10.1210/jcem.84.12.6222. ISSN 0021-972X. PMID 10599691.
  13. ^ Murray, P. G.; Clayton, P. E. (2000). "Disorders of Growth Hormone in Childhood". In De Groot, Leslie J.; Chrousos, George; Dungan, Kathleen; Feingold, Kenneth R.; Grossman, Ashley; Hershman, Jerome M.; Koch, Christian; Korbonits, Márta; McLachlan, Robert (eds.). Endotext. South Dartmouth (MA): MDText.com, Inc. PMID 25905205.
  14. ^ Shim, Kye Shik (March 2015). "Pubertal growth and epiphyseal fusion". Annals of Pediatric Endocrinology & Metabolism. 20 (1): 8–12. doi:10.6065/apem.2015.20.1.8. ISSN 2287-1012. PMC 4397276. PMID 25883921.
  15. ^ a b Laron, Z (October 2001). "Insulin-like growth factor 1 (IGF-1): a growth hormone". Molecular Pathology. 54 (5): 311–316. doi:10.1136/mp.54.5.311. ISSN 1366-8714. PMC 1187088. PMID 11577173.
  16. ^ a b Lupu, Floria; Terwilliger, Joseph D.; Lee, Kaechoong; Segre, Gino V.; Efstratiadis, Argiris (2001). "Roles of growth hormone and insulin-like growth factor 1 in mouse postnatal growth". Developmental Biology. 229 (1): 141–162. doi:10.1006/dbio.2000.9975. PMID 11133160.
  17. ^ Sanders, Esmond J.; Harvey, Steve (2004). "Growth hormone as an early embryonic growth and differentiation factor". Anatomy and Embryology. 209 (1): 1–9. doi:10.1007/s00429-004-0422-1. PMID 15480774. S2CID 19528310.
  18. ^ a b De Mais, Daniel. ASCP Quick Compendium of Clinical Pathology, 2nd Ed. ASCP Press, Chicago, 2009.
  19. ^ Trivellin, Giampaolo; Daly, Adrian F.; Faucz, Fabio R.; Yuan, Bo; Rostomyan, Liliya; Larco, Darwin O.; Schernthaner-Reiter, Marie Helene; Szarek, Eva; Leal, Letícia F. (2014). "Gigantism and Acromegaly Due to Xq26 Microduplications and GPR101 Mutation". New England Journal of Medicine. 371 (25): 2363–2374. doi:10.1056/nejmoa1408028. PMC 4291174. PMID 25470569.
  20. ^ a b Beckers, Albert; Aaltonen, Lauri A.; Daly, Adrian F.; Karhu, Auli (1 April 2013). "Familial Isolated Pituitary Adenomas (FIPA) and the Pituitary Adenoma Predisposition due to Mutations in the Aryl Hydrocarbon Receptor Interacting Protein (AIP) Gene". Endocrine Reviews. 34 (2): 239–277. doi:10.1210/er.2012-1013. ISSN 0163-769X. PMC 3610678. PMID 23371967.
  21. ^ Vierimaa, Outi; Georgitsi, Marianthi; Lehtonen, Rainer; Vahteristo, Pia; Kokko, Antti; Raitila, Anniina; Tuppurainen, Karoliina; Ebeling, Tapani M. L.; Salmela, Pasi I. (26 May 2006). "Pituitary Adenoma Predisposition Caused by Germline Mutations in the AIP Gene". Science. 312 (5777): 1228–1230. Bibcode:2006Sci...312.1228V. doi:10.1126/science.1126100. ISSN 0036-8075. PMID 16728643. S2CID 37013760.
  22. ^ Rostomyan, Liliya; Daly, Adrian F.; Beckers, Albert (2015). "Pituitary gigantism: Causes and clinical characteristics". Annales d'Endocrinologie. 76 (6): 643–649. doi:10.1016/j.ando.2015.10.002. PMID 26585365.
  23. ^ a b c d Goldenberg, Naila; Racine, Michael S.; Thomas, Pamela; Degnan, Bernard; Chandler, William; Barkan, Ariel (1 August 2008). "Treatment of Pituitary Gigantism with the Growth Hormone Receptor Antagonist Pegvisomant". The Journal of Clinical Endocrinology & Metabolism. 93 (8): 2953–2956. doi:10.1210/jc.2007-2283. ISSN 0021-972X. PMC 2515082. PMID 18492755.
  24. ^ Rix, M.; Laurberg, P.; Hoejberg, A. S.; Brock-Jacobsen, B. (1 August 2005). "Pegvisomant therapy in pituitary gigantism: successful treatment in a 12-year-old girl". European Journal of Endocrinology. 153 (2): 195–201. doi:10.1530/eje.1.01956. ISSN 0804-4643. PMID 16061823.
  25. ^ . Question.com. Archived from the original on 13 March 2012. Retrieved 14 March 2012.
  26. ^ In a Giant's Story, a New Chapter Writ by His DNA – By Gina Kolata. The New York Times, January 5, 2011

Bibliography

External links

 
Wikimedia Commons has media related to Gigantism.
  • (PDF). Archived from the original (PDF) on 22 May 2004. Retrieved 30 August 2004. (2.95 MB)
  • Gigantism Clinical Trials from U.S. National Institutes of Health
  • Gigantism information from U.S. National Library of Medicine, U.S. Department of Health and Human Services & the National Institutes of Health
  • Epidemiology of acromegaly from Pubmed.gov US National Library of Medicine & National Institutes of Health

March 08, 2023
gigantism, confused, with, deep, gigantism, island, gigantism, greek, γίγας, gígas, giant, plural, γίγαντες, gígantes, also, known, giantism, condition, characterized, excessive, growth, height, significantly, above, average, humans, this, condition, caused, o. Not to be confused with Deep sea gigantism or Island gigantism Gigantism Greek gigas gigas giant plural gigantes gigantes also known as giantism is a condition characterized by excessive growth and height significantly above average In humans this condition is caused by over production of growth hormone 2 in childhood resulting in people up to 2 7 m 9 0 ft in height 3 4 5 6 GigantismOther namesGiantismRobert Wadlow stood 8 ft 11 in 2 72 m SpecialtyEndocrinologySymptomsAbnormal growth in height or size weakness and insomnia 1 ComplicationsExcessive sweating delayed puberty weakness and severe or recurrent headaches common stroke vomiting high fevers sleepiness dry mouth diarrhea stomachache ear pain memory loss back painCausesHyperplasia in the pituitary glandTreatmentSurgically remove the enlarged pituitary glandMedicationOctreotide lanreotide or pegvisomantIt is a rare disorder resulting from increased levels of growth hormone before the fusion of the growth plate which usually occurs at some point soon after puberty This increase is most often due to abnormal tumor growths on the pituitary gland 7 8 Gigantism should not be confused with acromegaly the adult form of the disorder characterized by somatic enlargement specifically in the extremities and face 9 10 Contents 1 Cause 1 1 Hormonal cause 1 2 Diagnostic testing 2 Genetics 3 Treatment 3 1 Pharmaceuticals 4 Terminology 5 See also 6 References 7 Bibliography 8 External linksCause EditGigantism is characterized by an excess of growth hormone GH The excess of growth hormone that brings about gigantism is virtually always caused by pituitary growths adenomas 8 These adenomas are on the anterior pituitary gland They can also cause overproduction of GH s hypothalamic precursor known as growth hormone releasing hormone GHRH 11 As a result of the excessive amounts of growth hormone children achieve heights that are well above normal ranges 12 The specific age of onset for gigantism varies between patients and gender but the common age that excessive growth symptoms start to appear has been found to be around 13 years 7 Other health complications such as hypertension may occur in pediatric patients with hyper secretion of growth hormone Characteristics more similar to those seen in acromegaly may occur in patients that are closer in age to adolescence since they are nearing growth plate fusion 13 Hormonal cause Edit Growth hormone GH and insulin like growth factor I IGF I are two substances that have been identified as influencing growth plate formation and bone growth and therefore gigantism Their specific mechanisms are still not well understood 7 14 More broadly GH and IGF have both been identified to be involved in most stages of growth embryonic prenatal and postnatal 15 16 Moreover the receptor gene for IGF has been shown to be particularly influential throughout various stages of development especially prenatally This is the same for GH receptor genes which have been known to drive overall growth throughout various pathways 15 17 Growth hormone is a precursor upstream of IGF I but each has its independent role in hormonal pathways Yet both seem to ultimately come together to have a joint effect on growth 16 Diagnostic testing Edit Evaluation of growth hormone hyper secretion cannot be excluded with a single normal GH level due to diurnal variation However a random blood sample showing markedly elevated GH is adequate for diagnosis of GH hyper secretion Additionally a high normal GH level that fails to suppress with administration of glucose is also sufficient for a diagnosis of GH hyper secretion 18 Insulin like growth factor 1 IGF 1 is an excellent test for evaluation of GH hyper secretion It does not undergo diurnal variation and will thus be consistently elevated in GH hyper secretion and therefore patients with gigantism A single normal IGF 1 value will reliably exclude GH hyper secretion 18 Genetics EditFinding a specific genetic cause for gigantism has proven to be difficult Gigantism is the primary example of growth hormone hyper secretion disorders a group of illnesses that are not yet deeply understood 7 Some common mutations have been associated with gigantism Pediatric gigantism patients have shown to have duplications of genes on a specific chromosome Xq26 Typically these patients also experienced an onset of typical gigantism symptoms before reaching the age of 5 This indicates a possible linkage between gene duplications and the gigantism 19 Additionally DNA mutations in the aryl hydrocarbon receptor interacting protein AIP gene are common in gigantism patients They have been found to be present in about 29 percent of patients with gigantism 8 AIP is labeled as a tumor suppressor gene and a pituitary adenoma disposition gene 8 20 Mutations in AIP sequencing can have deleterious effects by inducing the development of pituitary adenomas which in turn can cause gigantism 8 20 Two specific mutations in the AIP gene have been identified as possible causes of pituitary adenomas These mutations also have the ability to cause adenoma growth to occur early in life 21 This is typical in gigantism Additionally a large variety of other known genetic disorders have been found to influence the development of gigantism such as multiple endocrine neoplasia type 1 and 4 McCune Albright syndrome Carney complex familial isolated pituitary adenoma X linked acrogigantism X LAG 8 22 Although various gene mutations have been associated with gigantism over 50 percent of cases cannot be linked to genetic causes showing the complex nature of the disorder 7 Treatment EditMany treatments for gigantism receive criticism and are not accepted as ideal Various treatments involving surgery and drugs have been used to treat gigantism 23 Pharmaceuticals Edit Pegvisomant is one pharmaceutical drug which has received attention for being a possible treatment route for gigantism Reduction of the levels of IGF I as a result of pegvisomant administration can be incredibly beneficial for the pediatric gigantism patients 23 After treatment with pegvisomant high growth rates a feature characteristic of gigantism can be significantly decreased 23 Pegvisomant has been seen to be a powerful alternative to other treatments such as somatostatin analogues a common treatment method for acromegaly if drug treatment is paired with radiation 24 Finding the optimal level of pegvisomant is important so normal body growth is not negatively affected In order to do this titration of the medication can be used as a way to find the proper administration level 23 See acromegaly for additional treatment possibilities Terminology Edit Daniel Cajanus 1704 1749 a Finnish giant Andre the Giant a wrestler and actor in The Princess Bride Giantess Anna Swan with her parents The term is typically applied to those whose height is not just in the upper 1 of the population but several standard deviations above mean for persons of the same sex age and ethnic ancestry The term is seldom applied to those who are simply tall or above average whose heights appear to be the healthy result of normal genetics and nutrition Gigantism is usually caused by a tumor on the pituitary gland of the brain It causes growth of the hands face and feet 25 better source needed In some cases the condition can be passed on genetically through a mutated gene 26 Other names somewhat obsolete for this pathology are hypersoma Greek hyper over the normal level soma body and somatomegaly Greek soma body genitive somatos of the body megas gen megalou great In the past while many of them were social outcasts because of their height some usually unintentionally found employment in Friedrich Wilhelm I s famous Potsdam Giants regiment Many of those who have been identified with gigantism have had multiple health problems involving the circulatory or skeletal system as the strain of maintaining a large heavy body places abnormal demands on both the bones and the heart See also EditAcromegaly Deep sea gigantism Dwarfism Giant of Castelnau Homo heidelbergensis Hypothalamic pituitary somatic axis Island gigantism List of humans with gigantism List of tallest people Local gigantism Marfan syndrome Megafauna Nephilim Overgrowth syndrome Sotos syndromeReferences Edit What causes gigantism healthline Gigantism at Dorland s Medical Dictionary Gigantism UCLA Pituitary Tumor Program pituitary ucla edu Retrieved 27 April 2017 Gigantism MedlinePlus Medical Encyclopedia medlineplus gov Retrieved 27 April 2017 Gigantism and Acromegaly Practice Essentials Background Pathophysiology and Etiology 7 January 2017 a href Template Cite journal html title Template Cite journal cite journal a Cite journal requires journal help Gigantism and Acromegaly Hormonal and Metabolic Disorders MSD Manual Consumer Version MSD Manual Consumer Version Retrieved 27 April 2017 a b c d e Rostomyan Liliya Daly Adrian F Petrossians Patrick Nachev Emil Lila Anurag R Lecoq Anne Lise Lecumberri Beatriz Trivellin Giampaolo Salvatori Roberto October 2015 Clinical and genetic characterization of pituitary gigantism an international collaborative study in 208 patients Endocrine Related Cancer 22 5 745 757 doi 10 1530 ERC 15 0320 ISSN 1479 6821 PMC 6533620 PMID 26187128 a b c d e f Rostomyan Liliya Potorac Iulia Beckers Pablo Daly Adrian F Beckers Albert 2017 AIP mutations and gigantism Annales d Endocrinologie 78 2 123 130 doi 10 1016 j ando 2017 04 012 PMID 28483363 Chanson Philippe Salenave Sylvie 25 June 2008 Acromegaly Orphanet Journal of Rare Diseases 3 17 doi 10 1186 1750 1172 3 17 ISSN 1750 1172 PMC 2459162 PMID 18578866 Capatina Cristina Wass John A H August 2015 60 YEARS OF NEUROENDOCRINOLOGY Acromegaly The Journal of Endocrinology 226 2 T141 160 doi 10 1530 JOE 15 0109 ISSN 1479 6805 PMID 26136383 Zimmerman D Young W F Ebersold M J Scheithauer B W Kovacs K Horvath E Whitaker M D Eberhardt N L Downs T R 1 January 1993 Congenital gigantism due to growth hormone releasing hormone excess and pituitary hyperplasia with adenomatous transformation The Journal of Clinical Endocrinology amp Metabolism 76 1 216 222 doi 10 1210 jcem 76 1 8421089 ISSN 0021 972X PMID 8421089 Eugster Erica A Pescovitz Ora H 1 December 1999 Gigantism The Journal of Clinical Endocrinology amp Metabolism 84 12 4379 4384 doi 10 1210 jcem 84 12 6222 ISSN 0021 972X PMID 10599691 Murray P G Clayton P E 2000 Disorders of Growth Hormone in Childhood In De Groot Leslie J Chrousos George Dungan Kathleen Feingold Kenneth R Grossman Ashley Hershman Jerome M Koch Christian Korbonits Marta McLachlan Robert eds Endotext South Dartmouth MA MDText com Inc PMID 25905205 Shim Kye Shik March 2015 Pubertal growth and epiphyseal fusion Annals of Pediatric Endocrinology amp Metabolism 20 1 8 12 doi 10 6065 apem 2015 20 1 8 ISSN 2287 1012 PMC 4397276 PMID 25883921 a b Laron Z October 2001 Insulin like growth factor 1 IGF 1 a growth hormone Molecular Pathology 54 5 311 316 doi 10 1136 mp 54 5 311 ISSN 1366 8714 PMC 1187088 PMID 11577173 a b Lupu Floria Terwilliger Joseph D Lee Kaechoong Segre Gino V Efstratiadis Argiris 2001 Roles of growth hormone and insulin like growth factor 1 in mouse postnatal growth Developmental Biology 229 1 141 162 doi 10 1006 dbio 2000 9975 PMID 11133160 Sanders Esmond J Harvey Steve 2004 Growth hormone as an early embryonic growth and differentiation factor Anatomy and Embryology 209 1 1 9 doi 10 1007 s00429 004 0422 1 PMID 15480774 S2CID 19528310 a b De Mais Daniel ASCP Quick Compendium of Clinical Pathology 2nd Ed ASCP Press Chicago 2009 Trivellin Giampaolo Daly Adrian F Faucz Fabio R Yuan Bo Rostomyan Liliya Larco Darwin O Schernthaner Reiter Marie Helene Szarek Eva Leal Leticia F 2014 Gigantism and Acromegaly Due to Xq26 Microduplications and GPR101 Mutation New England Journal of Medicine 371 25 2363 2374 doi 10 1056 nejmoa1408028 PMC 4291174 PMID 25470569 a b Beckers Albert Aaltonen Lauri A Daly Adrian F Karhu Auli 1 April 2013 Familial Isolated Pituitary Adenomas FIPA and the Pituitary Adenoma Predisposition due to Mutations in the Aryl Hydrocarbon Receptor Interacting Protein AIP Gene Endocrine Reviews 34 2 239 277 doi 10 1210 er 2012 1013 ISSN 0163 769X PMC 3610678 PMID 23371967 Vierimaa Outi Georgitsi Marianthi Lehtonen Rainer Vahteristo Pia Kokko Antti Raitila Anniina Tuppurainen Karoliina Ebeling Tapani M L Salmela Pasi I 26 May 2006 Pituitary Adenoma Predisposition Caused by Germline Mutations in the AIP Gene Science 312 5777 1228 1230 Bibcode 2006Sci 312 1228V doi 10 1126 science 1126100 ISSN 0036 8075 PMID 16728643 S2CID 37013760 Rostomyan Liliya Daly Adrian F Beckers Albert 2015 Pituitary gigantism Causes and clinical characteristics Annales d Endocrinologie 76 6 643 649 doi 10 1016 j ando 2015 10 002 PMID 26585365 a b c d Goldenberg Naila Racine Michael S Thomas Pamela Degnan Bernard Chandler William Barkan Ariel 1 August 2008 Treatment of Pituitary Gigantism with the Growth Hormone Receptor Antagonist Pegvisomant The Journal of Clinical Endocrinology amp Metabolism 93 8 2953 2956 doi 10 1210 jc 2007 2283 ISSN 0021 972X PMC 2515082 PMID 18492755 Rix M Laurberg P Hoejberg A S Brock Jacobsen B 1 August 2005 Pegvisomant therapy in pituitary gigantism successful treatment in a 12 year old girl European Journal of Endocrinology 153 2 195 201 doi 10 1530 eje 1 01956 ISSN 0804 4643 PMID 16061823 Gigantism Question com Archived from the original on 13 March 2012 Retrieved 14 March 2012 In a Giant s Story a New Chapter Writ by His DNA By Gina Kolata The New York Times January 5 2011Bibliography EditDriesbach Jason 2016 4QSamuela and the Text of Samuel BRILL ISBN 978 90 04 32420 6 External links Edit Wikimedia Commons has media related to Gigantism Brief overview of overgrowth syndromes in childhood PDF Archived from the original PDF on 22 May 2004 Retrieved 30 August 2004 2 95 MB Gigantism Clinical Trials from U S National Institutes of Health Gigantism information from U S National Library of Medicine U S Department of Health and Human Services amp the National Institutes of Health Epidemiology of acromegaly from Pubmed gov US National Library of Medicine amp National Institutes of Health Retrieved from https en wikipedia org w index php title Gigantism amp oldid 1138082886, wikipedia, wiki, book, books, library,

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