A 17-year-old boy is taken by his parents to a pediatrician because the parents are concerned about his
excessive height and his complaints of fatigue and general lassitude. His standing height is 84 in. Questioning reveals that the boy has grown very rapidly since his thirteenth birthday. As a young child, he excelled in competitive sports, but for the past 3 years, he has experienced weakness and fatigue and has ceased to compete. His nose is broad, and his mandible and facial features appear larger than normal. He has large hands and feet and takes a size 18 shoe. There is no family history of unusual tallness. The patient is of normal intelligence, and the size of his external genitalia is normal for his age. His secondary sexual characteristics are normal. Using your knowledge of anatomy and physiology, make a diagnosis. Which cell groups are likely to have undergone pathologic changes? How do you account for the excessive tallness and the presence of a large mandible, hands, and feet in the same individual?

Question

Quizplus · Accepted Answer

The Answer is This patient has the signs and symptoms of gigantism and acromegaly caused by the excessive secretion of growth hormone by the acidophil cells of the anterior lobe of the pituitary gland. The condition started before the epiphyses of the long bones fused with the diaphysis, hence the gigantism, and continued growth after the fusion had taken place, hence the acromegalic changes.

A 17-Year-Old Boy Is Taken by His Parents to a Pediatrician