Acromegaly and gigantism

DDx

• Pseudoacromegaly (acromegaly features, insulin resistance)
• Inactive ("burned-out") acromegaly (spontaneous remission due to pituitary adenoma infarction)
• Physiologic growth spurt
• Familial coarse features
• Familial large hands and feet
• Myxedema
• Isolated prognathism (jaw protrusion)

• Familial tall stature
• Aromatase deficiency
• Estrogen receptor deficiency

• Exercise or eating prior to test, acute illness or agitation, hepatic or renal failure, malnourishment, diabetes mellitus, estrogens, beta blockers, clonidine