Acromegaly. Cartilaginous fish are different from bony fish. Swelling of the tongue due to dehydration

Tongue edema is a condition in which the tongue increases in size. The entire tongue may swell, or one area - the tip, base (root of the tongue), one side - left or right.

Sometimes swelling spreads to the larynx, gums, palate, lips, and taste buds on the tongue. Extensive swelling can cause difficulty breathing, eating, and speaking.

Weak and short-lived enlargement of the tongue is most often a manifestation of a common infection or minor injury. But if the swelling does not subside, this may indicate serious problem with health.

Signs of tongue swelling

Here is a list of symptoms that may accompany tongue swelling:

• difficulties chewing, swallowing, talking;
• changing its color;
• difficulty breathing in case of severe swelling;
• swollen The lymph nodes under the lower jaw;
• bumps, ulcers, and irritated areas may appear on the tongue;
• pain and burning sensation in the tongue and throat;
• fever, chills and headache;
• bleeding even with slight injuries to the tongue;
• swelling of the lips, throat, gums, and taste buds on the tongue.

Causes

There are many reasons that lead to swelling of the tongue, we will list the most common ones.

Injuries

The most common reason swollen tongue - trauma (accidental biting, burns, damage from dental instruments, recovery from oral surgery, piercing).

Tongue injuries often occur during attacks of epileptic seizures. The jaw reflexively clenches and bites it. Caregivers can damage the tongue while trying to prevent the epileptic from swallowing it.

Use chewing tobacco also irritates the tongue and may cause swelling.

Allergic edema

A common cause of swelling is allergies. The tongue swells after eating allergenic foods or being stung by a bee or wasp. Other allergens are ACE inhibitor drugs used for heart diseases, non-steroidal anti-inflammatory drugs (ibuprofen, aspirin, naproxen).

At allergic urticaria, which can be caused by any allergen, occurs strong feeling itching and the tongue becomes blistered.

Allergic edema usually develops suddenly. Often not only the tongue swells, but also the lips and gums, swelling appears on the face, and the eyelids swell.

Other symptoms allergic reaction– sneezing, runny nose, cough, skin rash, gastrointestinal symptoms (vomiting, stomach upset).

Serious allergic reaction - anaphylactic shock, is developing very quickly. Symptoms that require immediate medical attention include swelling of the larynx, shortness of breath, rapid breathing, strong pain, severe swelling at the site of allergen injection.

Diseases

There are a number of diseases that can lead to tongue swelling.

Amyloidosis

Amyloidosis is a disorder of protein metabolism that often develops in older people. With this disease, the tongue gradually enlarges and swelling persists for a long time.

Tongue cancer

For early stage Tongue cancer is characterized by painless ulcers and bumps on this organ, as well as reddened areas or white spots on the surface of the mucous membrane. The tongue gradually increases in size.

Later stages of the disease are accompanied by pain, bleeding from the mouth, numbness individual areas oral cavity, constantly sore throat. Problems with eating and speech quickly arise.

Tongue cancer can be successfully treated if the disease is diagnosed early enough. If you notice similar symptoms that last more than two weeks, you should consult a doctor.

Herpes virus

The symptom of herpes is not only a “cold on the lips”. At herpetic lesion tongue swelling is usually accompanied by pain and the appearance of blisters on the surface of the tongue.

The blisters disappear after one to two weeks, but antiviral medications such as acyclovir can speed healing.

Fungal infection

Fungal infections of the oral cavity often occur in children, in adults after treatment with antibiotics, or when immune defenses are weakened.

With oral thrush, areas of thick thick tissue cover the tongue. white plaque, which are difficult to remove. Often the tongue is swollen and painful.

Fungal infections are quickly and easily treated antifungal drugs, for example, using fluconazole. If thrush occurs frequently in an adult, you should check your immune status and get tested for HIV.

Thyroid deficiency (hypothyroidism)

Hypothyroidism is a metabolic disorder in which thyroid does not produce enough hormones. Symptoms of hypothyroidism - fatigue, depression, dryness skin, weight gain, muscle weakness, joint pain, thinning hair.

Sometimes in case of insufficiency thyroid gland swelling of the face is observed. The tongue swells and teeth marks are often visible along the edges.

Scarlet fever

Scarlet fever is a bacterial infection that most often occurs in children between the ages of five and fifteen. Symptoms of the disease are a small red rash, sore throat, nausea, heat, enlarged lymph nodes in the neck. On the second to fourth day, the tongue becomes smooth, bright red and swollen. Sometimes the tongue first becomes white or yellow plaque, which disappears after a few days, leaving a smooth, crimson-colored surface.

Inflammation of the tongue (glossitis)

When inflamed, the tongue increases in size, the surface becomes smooth and burgundy. There is a pale white coating.

Inflammation develops against the background of allergies, after injury. The development of glossitis can be provoked by infection, burns from hot food, alcohol abuse, insufficient saliva, smoking, and hormonal factors.

Ways to combat glossitis are good oral hygiene and a gentle diet. If the inflammation is infectious, antibiotics are prescribed.

Angioedema

Angioedema is a condition of an allergic nature, but is sometimes inherited. As a rule, the lips, mouth, throat, and tongue are involved in the process. There is no itching, skin color does not change. The size of the swelling increases rapidly. Unlike urticaria, this type of allergic reaction affects a deeper layer of tissue. If swelling affects the mucous membrane of the throat, suffocation and death can occur.

Other diseases that cause swelling of the tongue

Below is a list of other medical conditions that can cause tongue swelling

• Infection due to advanced caries
• Herpangina with ulcers caused by the Coxsackie virus
• Anemia caused by vitamin B12 deficiency
• Multiple myeloma
• Kawasaki syndrome
• Streptococcal infection
• Syphilis
• Problems with the pituitary gland
• Rhabdomyolysis
• Leukemia
• Neurofibromatosis type 1 or oral neurofibroma
• Sarcoma
• Inflammation of the taste buds on the tongue
• Genetic diseases such as Down syndrome or Beckwith-Wiedemann syndrome

Swelling of the tongue due to dehydration

With a lack of fluid in the body (dehydration), a feeling of dryness occurs in the mouth, the tongue increases in size and becomes covered with cracks. Other symptoms of dehydration include dry and cracked lips, loose dry skin, urine bright yellow color, burning sensation when urinating

If such symptoms appear, you should drink enough fluids. Dehydration is a serious condition that can lead to death.

Causes based on the location of the swelling

Swelling under the tongue (“ball under the tongue”)

If swelling occurs under the tongue, this indicates a problem with the salivary glands. There are many reasons for this condition - infection, stones in salivary glands, parotitis(mumps), HIV, influenza, parainfluenza type 1 or 2, herpes, tumor, poor oral hygiene.

Swelling on one side of the tongue

Unilateral swelling of the tongue does not indicate a specific disease; it can also be caused by a number of diseases - bacterial infection, herpes virus, tumor.

Sometimes one side of the tongue swells after an injury - a burn, a bite, or after surgical intervention. An allergic reaction and angioedema often affects a specific area of ​​the tongue - the tip, left or right side.

Swollen tongue after piercing

After a piercing puncture, the tongue swells. The swelling usually subsides within a few days.

But if the piercing causes infection in the tissue of the tongue, it may remain swollen for several months or even years. Signs of a bacterial infection include redness, discharge from the tongue, bleeding, abscesses, bumps or blisters on the tongue.

Edema in children

Swelling of the tongue in children can be caused by many reasons - allergies, injury, inflammation, dehydration. If swelling occurs, you should consult a doctor.

Swelling with teeth marks around the edges

Sometimes the swollen tongue shows marks from the teeth along the edges. This language occurs when there is a lack useful substances in the body, problems with the thyroid gland, water retention in the body (due to diabetes, enlargement or inflammation of the liver). Sometimes the condition can be caused by problems with the spleen, which is often accompanied by bloating and overweight. If the problem is the spleen, then eating foods that are healthy for it (vegetables, herbs) can help.

Swelling of the tongue and sore throat

Swelling of the tongue in combination with a sore throat may be a sign of an allergic reaction, Quincke's edema, oral infection, mononucleosis, or oral cancer.

In an allergic reaction, a sore throat is accompanied by difficulty breathing, rash, and runny nose. Symptoms of viral mononucleosis - elevated temperature, feeling tired, enlarged and painful lymph nodes, headache.

Treatment

Treatment for tongue swelling depends on the cause of the condition.

Treatment of allergic edema

At allergic edema First of all, you need to identify the allergen substance and eliminate contact with the allergen. Used to treat allergies antihistamines and corticosteroids. In case of severe swelling, methylprednisolone, Benadryl, and adrenaline injections are used.

Treatment of infectious edema

For treatment infectious edema you should consult a doctor. Bacterial infections treated with antibiotics, viral diseases medications are prescribed to reduce the symptoms of a viral infection.

Traumatic edema

Serious tongue injuries require medical intervention– you need to stop the bleeding and reduce swelling. For minor injuries, you can apply a piece of ice to the tongue and use painkillers.

Treatment with home remedies

When treating edema, various home remedies that happen to be at hand can be used.

• To care for your tongue, use a soft toothbrush. Use a brush to gently clean your tongue periodically.
• A lump of sugar on the tongue can reduce swelling.
• A diluted turmeric solution (water and turmeric powder) reduces inflammation. Rinsing your mouth with a solution sea ​​salt helps with both viral and bacterial infections.

Pathological increase individual parts body associated with increased production somatotropic hormone (growth hormone) by the anterior pituitary gland as a result of its tumor lesion. Occurs in adults and is manifested by enlargement of facial features (nose, ears, lips, lower jaw), enlargement of the feet and hands, constant headaches and pain in the joints, sexual and reproductive functions in men and women. Increased level growth hormone in the blood causes early mortality from cancer, pulmonary, cardiovascular diseases.

With acromegaly, there is excessive sweating and sebum secretion due to an increase in the amount and increased activity sweat and sebaceous glands. The skin of patients with acromegaly thickens, thickens, and gathers into deep folds, especially in the scalp.

With acromegaly, there is an increase in muscle size and internal organs(heart, liver, kidneys) with gradual increasing degeneration muscle fibers. Patients begin to experience weakness, fatigue, and a progressive decrease in performance. Myocardial hypertrophy develops, which is then replaced by myocardial dystrophy and increasing heart failure. A third of patients with acromegaly experience arterial hypertension, almost 90% develop sleep apnea syndrome associated with hypertrophy of the soft tissues of the upper respiratory tract and disruption of the respiratory center.

Suffering from acromegaly sexual function. Most women with an excess of prolactin and a deficiency of gonadotropins develop menstrual irregularities and infertility, galactorrhea appears - milk discharge from the nipples, not caused by pregnancy and childbirth. 30% of men experience a decrease in sexual potency. Hyposecretion of antidiuretic hormone in acromegaly is manifested by the development of diabetes insipidus.

As the pituitary tumor grows and compression of nerves and tissues occurs, an increase in intracranial pressure, photophobia, double vision, pain in the cheekbones and forehead, dizziness, vomiting, decreased hearing and sense of smell, numbness of the extremities. Patients suffering from acromegaly have an increased risk of developing tumors of the thyroid gland, organs gastrointestinal tract, uterus.

Complications of acromegaly

The course of acromegaly is accompanied by the development of complications from almost all organs. The most common conditions in patients with acromegaly include cardiac hypertrophy, myocardial dystrophy, arterial hypertension, heart failure. More than a third of patients develop diabetes mellitus, liver dystrophy and pulmonary emphysema are observed.

Overproduction of growth factors in acromegaly leads to the development of tumors various organs, both benign and malignant. Acromegaly is often accompanied by diffuse or nodular goiter, fibrocystic mastopathy, adenomatous adrenal hyperplasia, polycystic ovary syndrome, uterine fibroids, and intestinal polyposis. Developing pituitary insufficiency (panhypopituitarism) is caused by compression and destruction of the pituitary gland by the tumor.

Diagnosis of acromegaly

IN late stages(5-6 years from the onset of the disease) acromegaly can be suspected based on an increase in body parts and other external signs noticeable upon inspection. In such cases, the patient is sent for a consultation with an endocrinologist and tests for laboratory diagnostics.

Main laboratory criteria Diagnosis of acromegaly is the determination of blood levels:

• somatotropic hormone in the morning and after the glucose test;
• IGF I - insulin-like growth factor.

An increase in somatotropin levels is detected in almost all patients with acromegaly. An oral test with a glucose load for acromegaly involves determining the initial value of growth hormone, and then after taking glucose - after half an hour, an hour, 1.5 and 2 hours. Normally, after taking glucose, the level of somatotropic hormone decreases, and when active phase acromegaly, on the contrary, its increase is noted. Carrying out a glucose tolerance test is especially informative in cases of a moderate increase in the level of growth hormone, or its normal values. The glucose load test is also used to evaluate the effectiveness of acromegaly treatment.

Growth hormone acts on the body through insulin-like growth factors (IGFs). The plasma concentration of IGF I reflects the total release of GH per day. An increase in IRF I in the blood of an adult directly indicates the development of acromegaly.

At ophthalmological examination in patients with acromegaly, there is a narrowing of the visual fields, because anatomically visual pathways located in the brain next to the pituitary gland. X-rays of the skull reveal an increase in the size of the sella turcica, where the pituitary gland is located. To visualize a pituitary tumor, computer diagnostics and MRI of the brain. In addition, patients with acromegaly are evaluated for various complications: intestinal polyposis, diabetes mellitus, many nodular goiter etc.

Treatment of acromegaly

For acromegaly, the main goal of treatment is to achieve remission of the disease by eliminating hypersecretion of somatotropin and normalizing the concentration of IGF I. To treat acromegaly, modern endocrinology uses medication, surgery, radiation and combined methods.

To normalize the level of somatotropin in the blood, somatostatin analogues are prescribed - a neurosecretion of the hypothalamus that suppresses the secretion of growth hormone (octreotide, lanreotide). For acromegaly, the use of sex hormones and dopamine agonists (bromocriptine, cabergoline) is indicated. Subsequently, one-time gamma or radiation therapy is usually performed on the pituitary gland area.

For acromegaly, the most effective is surgical removal of the tumor at the base of the skull through sphenoid bone. At small sizes adenomas after surgery in 85% of patients there is normalization of somatotropin levels and stable remission of the disease. With significant tumor sizes, the cure rate after the first operation reaches 30%. Mortality rate for surgical treatment acromegaly ranges from 0.2 to 5%.

Forecast and prevention of acromegaly

Lack of treatment for acromegaly leads to disability in patients of active and working age and increases the risk of premature mortality. With acromegaly, life expectancy is reduced: 90% of patients do not live to age 60. Death usually occurs as a result of cardiovascular disease. results surgical treatment acromegaly is better for small-sized adenomas. With large pituitary tumors, the frequency of their relapses increases sharply.

To prevent acromegaly, you should avoid head injuries, sanitize chronic lesions nasopharyngeal infections. Early detection of acromegaly and normalization of growth hormone levels will avoid complications and cause stable remission of the disease.

All-Russian Olympiad for schoolchildren in biology 2015

for 10th grade

Full name of the student__________________________________________________________

School________________________________________________________________

Teacher_______________________________________________________________

Exercise 1. The task includes 36 questions, each of them has 4 possible answers. For each question, you must select only one answer, which is the most complete and correct. The index of the selected answer must be entered into the answer matrix. For each correct answer, the Olympiad participant receives 1 point.

1. Plants differ from animals, first of all:

A) cellular structure body; b) way of eating; c) differences in chemical composition cells; d) the presence of vacuoles.

2. K higher plants relate:

a) purple algae; b) multicellular green algae; c) mosses; d) cyanides.

3. Mushrooms are classified into a separate kingdom because:

a) they are immobile, but capable of photosynthesis; b) their cells contain chitin, and their body consists of mycelium; c) reproduce by spores and have no organs; d) have no organs, heterotrophs.

Which of the named mushrooms belongs to the lamellar mushrooms?

a) boletus; b) oiler; c) saffron milk cap; d) boletus.

5. Mushrooms are similar to some plants:

a) reproduction by spores; b) autotrophic method of nutrition; c) heterotrophic mode of nutrition; d) absence cell wall.

6. Viruses have such signs of living things as:

a) food; b) growth; c) metabolism; d) heredity.

7. Viruses are classified as precellular organisms because they:

8. Cartilaginous fish are different from bony fish:

a) lack of scales; b) absence of a swim bladder; c) the presence of gill covers; d) two-chamber heart.

9. Branch of zoology that studies animal behavior:

a) morphology; b) ethology; c) herpetology; d) arachnology.

10. The fruiting bodies of cap mushrooms are used for:

a) formation of disputes; b) vegetative propagation; d) savings nutrients;

e) experiencing unfavorable conditions.

11 . Among reptiles eardrum missing from:

a) crocodiles; b) turtles; c) snakes; d) lizards.

12. The central nervous system of chordates has the form:

a) stairs; b) strings; c) tourniquet; d) tubes.

13. Dioecious:

a) white planaria; b) liver fluke; c) bovine tapeworm; d) human roundworm.

14. There is no intermediate host in:

a) liver fluke; b) bovine tapeworm; V) pork tapeworm; d) human roundworm.

What type of bones are vertebrae?

a) spongy long; b) spongy short; c) flat; d) tubular short.

The taste zone is located in... the lobe of the cerebral hemispheres.

a) temporal; b) occipital; c) frontal; d) parietal.

Which skin cells are not capable of dividing?

a) cells skin glands; b) cells of the upper layer of the epidermis;

c) cells hair follicle; d) cells of the deep layer of the epidermis.

18. The placenta does not provide:

a) removal of metabolic products; b) oxygen supply; c) supply of nutrients; d) synthesis of hormones and antibodies.

19. The main humoral regulator of respiration is:

a) adrenaline; b) oxygen; c) norepinephrine; d) carbon dioxide.

20. The patient has an enlarged nose, lips, tongue, hands, and feet; the voice is rough because the vocal cords are thickened. What diagnosis will the endocrinologist make?

a) acromegaly; b) Graves' disease; V) bronze disease; d) gigantism.

21. Lancelet belongs to the systematic group:
a) invertebrates; b) gillless; c) skullless; d) legless.

22. Intraspecific competition is:

a) abiotic factor; b) biotic factor; c) anthropogenic factor; d) psychological factor.

23. Cells or cellular structures can be divided according to their density using the method:

24. Bactericidal effect provide:

A) ultra-violet rays; b) visible light rays; c) infrared rays; d) electromagnetic radio waves.

25. The presence of centrioles and the absence of a cell wall is characteristic of cells:

a) mushrooms; b) bacteria; c) plants; d) animals.

a) dodder - clover; b) ant - aphid; c) aspen - boletus; d) mongoose - rat.

27. Which cell organelles do not have membranes:

a) mitochondria; c) lysosomes; b) ribosomes; d) plastids.

Most often, patients complain of headaches, pain in the arms and joints of the extremities, changes in appearance and enlargement (more precisely, expansion and thickening) of the hands and feet. Later, muscle weakness and increased fatigue appear.

Headache, initially episodic, gradually intensifies and can become intense, constant, with a predominant localization in the frontotemporal or occipital areas. It is apparently caused by an increase in intracranial pressure or compression of the sella diaphragm by the tumor. Headache can be combined with dizziness, tinnitus, blurred vision, and diplopia. Eye symptoms caused by compression of surrounding tissues by the tumor, paralysis oculomotor nerve. The appearance changes due to the enlargement of the nose, lower jaw, zygomatic and brow ridges. As a result of foot enlargement, patients note a change in shoe size. There are frequent complaints about decreased sexual function: in men - impotence, in women - violation menstrual cycle up to amenorrhea.

During an objective examination of the patient in case characteristic changes The large disproportionate skull attracts attention: the superciliary and zygomatic arches, nose, ears, and tongue are unevenly enlarged. Significantly enlarged and protruding forward lower jaw(prognathism). The tongue is large, thick, with teeth marks on the edges, and is difficult to fit into the oral cavity. Large hands and feet. The eyes are set deep in the orbit due to prominent brow ridges. The characteristic appearance of the patients makes them surprisingly similar to each other. Voice becomes rough due to thickening vocal cords and cartilages of the larynx. The skin thickens and gathers into folds. Increased hair growth is observed, and women develop hypertrichosis - hair growth on the face and body. As the disease progresses, the hair on the head falls out. Muscle hypertrophy, characteristic of the onset of the disease, is later replaced by muscle atrophy and muscle weakness.

X-ray changes in the skeletal bones are typical for acromegaly. In addition to the indicated growths of the skull bones, most patients exhibit enlargement and expansion of the sella turcica, thinning (osteoporosis) back wall up to its complete destruction. The bottom of the sella turcica may have double contours. A large tumor sometimes destroys the sinus of the underlying bone. The bones of the calvarium and occipital bone are thickened (hyperostosis). There is increased pneumatization of the skull bones, the paranasal sinuses are enlarged. Rib cage increases in size, intercostal spaces widen, ribs thicken. As a result of spinal deformation, kyphosis and scoliosis develop. The bones of the limbs, especially the hands and feet, thicken. The hands and feet increase in diameter. Flat feet are often noted. Bone spines grow along the edges of the vertebrae and phalanges of the fingers. The joints become deformed, thicken, and movements in them are painful. Pathological joint mobility may occur early diagnostic sign acromegaly. As the disease progresses, joint mobility is limited.

The heart in acromegaly enlarges due to proliferation connective tissue and hypertrophy of muscle fibers. Subsequently, myocardial dystrophy develops with signs of heart failure. The ECG reveals symptoms of intraventricular conduction disturbances, expansion of the QRS complex, and a decrease in the S-T interval. Due to the expansion and limitation of chest mobility and the development of emphysema, patients are easily susceptible to bronchopneumonia and tuberculosis.

The liver is often enlarged due to a number of reasons: splanchnomegaly, heart failure and diabetic hepatitis. Organ enlargement abdominal cavity also applies to the spleen, kidneys, and digestive tract.

In 1/3 of patients with acromegaly, carbohydrate metabolism, which is expressed in a decrease in tolerance to carbohydrates, the appearance pathological reaction on glucose load. In 15-20% of cases, these violations can become obvious diabetes. The cause of diabetes in acromegaly is the counter-insulin action of growth hormone. At the beginning of the disease, this is accompanied by compensatory hyperproduction of insulin, later exhaustion occurs functional state insular apparatus and hyperglycemia. Diabetes in patients with acromegaly is usually not severe, but there may be insulin-resistant forms. As successful treatment acromegaly, removal of pituitary adenoma, diabetes mellitus can be eliminated.

Violation fat metabolism manifested by hyperlipidemia, increased cholesterol levels in the blood.

From the outside endocrine glands a two-phase reaction is observed. At the onset of the disease, due to increased production of tropic hormones of the pituitary gland, hyperplasia of the thyroid and parathyroid glands, as well as the adrenal glands and gonads, is observed. In the clinic, this sometimes finds expression in the development of symptoms of thyrotoxicosis, increased excretion of adrenal hormones (17-OX and 17-KS) in the urine, and increased function of the gonads. Hyperplasia of the thyroid gland, which occurs under the influence of somatotropin, leads to the development of diffuse or nodular goiter in 20-30% of patients. In the later stages of the disease, hyperfunction of the endocrine glands is replaced by their hypofunction, which especially demonstrably affects the function of the adrenal glands (in the form of hypocorticism) and gonads.

A.Efimov, N.Skrobonskaya, A.Cheban

“Headache, pain in the arms and joints, thickening of the hands and feet and other symptoms of acromegaly” - article from the section

Clinical picture. Patients with acromegaly complain of headache, sexual dysfunction, changes in appearance, voices, blurred vision, memory, muscle pain etc. Upon examination, attention is drawn to the enlargement of the brow ridges, cheek bones, ears, nose, lips, tongue, hands, feet, calcaneal bones. The lower jaw often protrudes forward (prognathism), and the gap between the teeth increases (diastema). The skin is thickened, with rough folds, especially on the face, less often on the scalp. Humidity and oiliness of the skin are increased, and increased pigmentation is often noted. Excessive hair growth on the body and face (hypertrichosis). The chest increases in volume and becomes barrel-shaped. The intercostal spaces widen. The sternum, collarbones, and ribs thicken. In some cases, kyphosis and scoliosis of the spine develop. Internal organs are often enlarged (splanchnomegaly).

When researching of cardio-vascular system cardiac hypertrophy, predominantly of the left ventricle, followed by dilatation, as well as progressive heart failure, are detected. More frequent, earlier and more pronounced development of atherosclerosis is noted. Blood pressure is often elevated. The ECG usually shows a levogram, deformation of the QRS complex, indicating a violation of intraventricular conduction, flattening or inversion of the T wave.

There is a tendency to bronchopneumonia, and emphysema often develops. Some patients experience peptic ulcer, malignant tumor stomach. Violation of the protein-forming function of the liver, a tendency to the formation of gall bladder stones, and the development of dyskinesia are often observed. biliary tract. With gigantism, the size of the internal organs is increased in proportion to growth, there are no signs of impairment of their function. Changes in vision with acromegaly are most often expressed by bitemporal hemianopsia (loss of temporal fields of vision on both sides), primarily in red and white colors. This is observed when atrophic changes in the cross optic nerves due to the pressure of the tumor on them during its extrasellar growth. In some cases, complete blindness may develop.

Neuromuscular disorders.

Neuromuscular disorders can be presented in the form of neuropathic and myopathic syndromes. Myopathic syndrome is caused by an increase in protein synthesis and muscle fiber mass due to excessive secretion of growth hormone. This syndrome causes muscle fatigue proximal sections arms and, less often, legs, painful muscle cramps. At the beginning of the disease, the muscles are hypertrophied, and sometimes their strength increases. If the disease arose long ago, muscle wasting and myopathy are more common. With myopathic syndrome, the muscles are dense, sometimes painful on palpation.

Neuropathic syndrome occurs due to changes in the ratio of dense tissues and increasing nerve trunks. It is characterized by acroparesthesia, pain and numbness of the hands and fingers at night, and weakness. IN severe cases atrophy of the hand muscles is observed. With acromegaly, compression neuropathies of the radial and median nerves may occur.

Central nervous system disorders are usually manifested by symptoms of increased intracranial pressure (headache with nausea and vomiting, dizziness, epileptoid seizures, congestive optic nerves, etc.). In case of dysfunction of the autonomic nervous system hyperhidrosis and instability occur blood pressure, hot flashes, tendency to tachycardia. Violations of the highest nervous activity manifested by apathy, lethargy, drowsiness, slowness, and memory loss. Glands internal secretion(thyroid, parathyroid, pancreas) in initial period diseases are usually hyperplastic, their function is increased. Due to high content in the body of prolactin in women is often disrupted menstrual cycle, amenorrhea and galactorrhea occur, and in men - hypogonadism.