Growthhormonesecreting

Growth hormone-secreting refers to tissues or tumors that produce growth hormone (GH). In humans, most GH is produced by somatotroph cells in the anterior pituitary gland. GH promotes growth and metabolism by stimulating IGF-1 production in the liver and other tissues. The release of GH is pulsatile and regulated by hypothalamic factors: growth hormone-releasing hormone (GHRH) stimulates secretion, while somatostatin inhibits it. Ghrelin from the stomach can also stimulate GH release.

Most commonly, growth hormone excess is caused by a somatotroph pituitary adenoma. In rare cases, ectopic GH secretion occurs from non-pituitary tumors or very rarely due to aberrant hormone production.

In children, excess GH before closure of the growth plates results in gigantism with increased linear growth. In adults, excess GH causes acromegaly, characterized by enlargement of the hands, feet, jaw, and facial features, along with soft tissue swelling, organomegaly, and metabolic disturbances such as glucose intolerance.

Diagnosis relies on biochemical and imaging studies. Serum IGF-1 levels reflect integrated GH secretion and are typically elevated in GH excess. GH suppression with an oral glucose tolerance test is usually failing; MRI of the pituitary identifies a somatotroph adenoma.

Treatment aims to reduce GH/IGF-1 activity and control symptoms. First-line therapy is usually transsphenoidal surgery to remove the pituitary tumor. When surgery is insufficient or not possible, medical therapy with somatostatin receptor ligands (e.g., octreotide, lanreotide), GH receptor antagonists (pegvisomant), or dopamine agonists can be used. Radiotherapy may be considered for residual disease.

Regular follow-up monitors IGF-1, GH levels, and clinical features to manage comorbidities and prevent complications such as cardiovascular disease and colon polyps.