Gigantism - wikipedia Gigantism Not to be confused with Deep - sea gigantism or Island gigantism. Gigantism, also known as giantism ( from Greek γίγας gigas, `` giant '', plural γίγαντες gigantes ), is a condition characterized by excessive growth and height significantly above average. In humans, this condition is caused by over-production of growth hormone in childhood resulting in people between 7 feet ( 2.13 m ) and 9 feet ( 2.72 m ) in height. Gigantism Classification and external resources Specialty Endocrinology ICD - 10 E22. 0, E34. 4 ICD - 9 - CM 253.0 DiseasesDB 30730 MedlinePlus 001174 MeSH D005877 ( edit on Wikidata ) 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 is most often due to abnormal tumor growths on the pituitary gland. Gigantism should not be confused with acromegaly, the adult form of the disorder, characterized by somatic enlargement specifically in the extremities and face. Contents 1 Cause 1.1 Hormonal cause 1.2 Diagnostic testing 2 Genetic 3 Treatment 3.1 Pharmaceuticals 4 Terminology 5 Society and culture 6 See also 7 References 8 External links Cause Gigantism is characterized by an excess of growth hormone ( GH ). This overproduction of growth hormone that brings about gigantism is virtually always caused by pituitary growths ( adenomas ). 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 ). As a result of the excessive amounts of growth hormone, children achieve heights that are well above normal ranges. 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. Other health complications may occur in pediatric patients with hyper - secretion of growth hormone such as hypertension. 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. Hormonal cause Growth hormone ( GH ) and insulin - like growth factor - I ( IGF - I ) are two different substances that have been identified as influencing growth plate formation and bone growth and, therefore, gigantism. The specific mechanisms of these are still not completely understood. More broadly, GH and IGF have both been identified to be involved most stages of growth : embryonic, prenatal, and postnatal. 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. Growth hormone is a precursor ( upstream ) of IGF - I, but each have their own independent roles in hormonal pathways. Yet both seem to ultimately come together to have a joint effect on growth. Diagnostic testing Evaluation of growth hormone hyper - secretion can not 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. 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. Genetic 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. 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. 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. AIP is labeled as a tumor suppressor gene and a pituitary adenoma disposition gene. Mutations in AIP sequencing can have deleterious effects by inducing the development of pituitary adenomas which in turn can cause gigantism. 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. 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 ). Although various gene mutations have been associated with gigantism, over 50 percent of cases can not be linked to genetic causes, showing the complex nature of the disorder. 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. 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. After treatment with pegvisomant, high growth rates, a feature characteristic of gigantism, can be significantly decreased. 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. 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. See acromegaly for additional treatment possibilities. Terminology 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. In some cases the condition can be passed on genetically through a mutated gene. 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 suffered from multiple health issues involving their circulatory or skeletal system, as the strain of maintaining a large, heavy body places abnormal demands on both the bones and the heart. Society and culture Main article : Giant ( mythology ) Reports of gigantism exist throughout history, with some nations and tribes taller than others. The giants of Crete are listed in various historic sources, beginning with Titan, a Greek mythological giant, and including Gigantus, after whom giants and gigantism are named. Rhodes is another island where giants were said to have lived, with the Colossus of Rhodes, a giant statue of a giant patron god Helios. Goliath, a giant mentioned in the Bible, was a Philistine warrior who was killed by David in a battle between the Israelites and the Philistines. A member of Goliath 's family is also recorded as having six fingers on each hand and six toes on each foot. See also Acromegaly Deep - sea gigantism Dwarfism Giant of Castelnau Growth hormone 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 References Jump up ^ `` Gigantism '' at Dorland 's Medical Dictionary Jump up ^ `` Gigantism UCLA Pituitary Tumor Program ''. pituitary.ucla.edu. Retrieved 2017 - 04 - 27. Jump up ^ `` Gigantism : MedlinePlus Medical Encyclopedia ''. medlineplus.gov. Retrieved 2017 - 04 - 27. Jump up ^ `` Gigantism and Acromegaly : Practice Essentials, Background, Pathophysiology and Etiology ''. 2017 - 01 - 07. Jump up ^ `` Gigantism and Acromegaly - Hormonal and Metabolic Disorders - MSD Manual Consumer Version ''. MSD Manual Consumer Version. Retrieved 2017 - 04 - 27. ^ Jump up to : 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. PMID 26187128. ^ Jump up to : Rostomyan, Liliya ; Potorac, Iulia ; Beckers, Pablo ; Daly, Adrian F. ; Beckers, Albert. `` AIP mutations and gigantism ''. Annales d'Endocrinologie. 78 ( 2 ) : 123 -- 130. doi : 10.1016 / j. ando. 2017.04. 012. Jump up ^ Chanson, Philippe ; Salenave, Sylvie ( 2008 - 06 - 25 ). `` Acromegaly ''. Orphanet Journal of Rare Diseases. 3 : 17. doi : 10.1186 / 1750 - 1172 - 3 - 17. ISSN 1750 - 1172. Jump up ^ 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. Jump up ^ Zimmerman, D ; Young, WF ; Ebersold, MJ ; Scheithauer, BW ; Kovacs, K ; Horvath, E ; Whitaker, MD ; Eberhardt, NL ; Downs, TR ( 1993 - 01 - 01 ). `` 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. Jump up ^ Eugster, Erica A. ; Pescovitz, Ora H. ( 1999 - 12 - 01 ). `` Gigantism ''. The Journal of Clinical Endocrinology & Metabolism. 84 ( 12 ) : 4379 -- 4384. doi : 10.1210 / jcem. 84.12. 6222. ISSN 0021 - 972X. Jump up ^ Murray, P.G. ; Clayton, P.E. ( 2000 ). 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. Jump up ^ 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. ^ Jump up to : 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. ^ Jump up to : Lupu, Floria ; Terwilliger, Joseph D. ; Lee, Kaechoong ; Segre, Gino V. ; Efstratiadis, Argiris. `` 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. Jump up ^ Sanders, Esmond J. ; Harvey, Steve. `` Growth hormone as an early embryonic growth and differentiation factor ''. Anatomy and Embryology. 209 ( 1 ) : 1 -- 9. doi : 10.1007 / s00429 - 004 - 0422 - 1. ^ Jump up to : De Mais, Daniel. ASCP Quick Compendium of Clinical Pathology, 2nd Ed. ASCP Press, Chicago, 2009. Jump up ^ Trivellin, Giampaolo ; Daly, Adrian F. ; Faucz, Fabio R. ; Yuan, Bo ; Rostomyan, Liliya ; Larco, Darwin O. ; Schernthaner - Reiter, Marie Helene ; Szarek, Eva ; Leal, Letícia F. `` 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. ^ Jump up to : Beckers, Albert ; Aaltonen, Lauri A. ; Daly, Adrian F. ; Karhu, Auli ( 2013 - 04 - 01 ). `` 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. Jump up ^ Vierimaa, Outi ; Georgitsi, Marianthi ; Lehtonen, Rainer ; Vahteristo, Pia ; Kokko, Antti ; Raitila, Anniina ; Tuppurainen, Karoliina ; Ebeling, Tapani M.L. ; Salmela, Pasi I. ( 2006 - 05 - 26 ). `` Pituitary Adenoma Predisposition Caused by Germline Mutations in the AIP Gene ''. Science. 312 ( 5777 ) : 1228 -- 1230. doi : 10.1126 / science. 1126100. ISSN 0036 - 8075. PMID 16728643. Jump up ^ Rostomyan, Liliya ; Daly, Adrian F. ; Beckers, Albert. `` Pituitary gigantism : Causes and clinical characteristics ''. Annales d'Endocrinologie. 76 ( 6 ) : 643 -- 649. doi : 10.1016 / j. ando. 2015.10. 002. ^ Jump up to : Goldenberg, Naila ; Racine, Michael S. ; Thomas, Pamela ; Degnan, Bernard ; Chandler, William ; Barkan, Ariel ( 2008 - 08 - 01 ). `` 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. ^ Jump up to : Goldenberg, Naila ; Racine, Michael S. ; Thomas, Pamela ; Degnan, Bernard ; Chandler, William ; Barkan, Ariel ( 2008 - 08 - 01 ). `` 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. Jump up ^ Rix, M. ; Laurberg, P. ; Hoejberg, A.S. ; Brock - Jacobsen, B. ( 2005 - 08 - 01 ). `` 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. Jump up ^ `` Gigantism ''. Question.com. Retrieved 2012 - 03 - 14. Jump up ^ In a Giant 's Story, a New Chapter Writ by His DNA - By Gina Kolata. The New York Times, January 5, 2011 Jump up ^ Story of Goliath in 1Samuel 17 -- 6 fingers in 1 Chronicles 20 : 6 cf. 2Samuel 21 : 20 - 22 External links Wikimedia Commons has media related to Gigantism. Acromegaly and Gigantism article `` Brief overview of overgrowth syndromes in childhood '' ( PDF ). ( 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 and Pathophysiology info for Healthcare Professionals Epidemiology of acromegaly from Pubmed.gov US National Library of Medicine & National Institutes of Health Diseases of the endocrine system ( E00 -- E35, 240 -- 259 ) Pancreas / glucose metabolism Hypofunction Diabetes mellitus types : type 1 type 2 gestational MODY 1 2 3 4 5 6 complications coma angiopathy ketoacidosis nephropathy neuropathy retinopathy cardiomyopathy insulin receptor ( Rabson -- Mendenhall syndrome ) Insulin resistance Hyperfunction Hypoglycemia beta cell ( Hyperinsulinism ) G cell ( Zollinger -- Ellison syndrome ) Hypothalamic / pituitary axes Hypothalamus gonadotropin Kallmann syndrome Adiposogenital dystrophy CRH ( Tertiary adrenal insufficiency ) vasopressin ( Neurogenic diabetes insipidus ) general ( Hypothalamic hamartoma ) Pituitary Hyperpituitarism anterior Acromegaly Hyperprolactinaemia Pituitary ACTH hypersecretion posterior ( SIADH ) general ( Nelson 's syndrome ) Hypopituitarism anterior Kallmann syndrome Growth hormone deficiency Hypoprolactinemia ACTH deficiency / Secondary adrenal insufficiency GnRH insensitivity FSH insensitivity LH / hCG insensitivity posterior ( Neurogenic diabetes insipidus ) general Empty sella syndrome Pituitary apoplexy Sheehan 's syndrome Lymphocytic hypophysitis Thyroid Hypothyroidism Iodine deficiency Cretinism Congenital hypothyroidism Myxedema Euthyroid sick syndrome Hyperthyroidism Hyperthyroxinemia Thyroid hormone resistance Familial dysalbuminemic hyperthyroxinemia Hashitoxicosis Thyrotoxicosis factitia Graves ' disease Thyroiditis Acute infectious Subacute De Quervain 's Subacute lymphocytic Autoimmune / chronic Hashimoto 's Postpartum Riedel 's Goitre Endemic goitre Toxic nodular goitre Toxic multinodular goiter Thyroid nodule Parathyroid Hypoparathyroidism Pseudohypoparathyroidism Pseudopseudohypoparathyroidism Hyperparathyroidism Primary Secondary Tertiary Osteitis fibrosa cystica Adrenal Hyperfunction aldosterone : Hyperaldosteronism / Primary aldosteronism Conn syndrome Bartter syndrome Glucocorticoid remediable aldosteronism AME Liddle 's syndrome 17α CAH cortisol : Cushing 's syndrome ( Pseudo-Cushing's syndrome ) sex hormones : 21α CAH 11β CAH Hypofunction / Adrenal insufficiency ( Addison 's, WF ) aldosterone : Hypoaldosteronism 21α CAH 11β CAH cortisol : CAH Lipoid 3β 11β 17α 21α sex hormones : 17α CAH Gonads ovarian : Polycystic ovary syndrome Premature ovarian failure testicular : enzymatic 5α - reductase deficiency 17β - hydroxysteroid dehydrogenase deficiency aromatase excess syndrome Androgen receptor ( Androgen insensitivity syndrome ) general : Hypogonadism ( Delayed puberty ) Hypergonadism Precocious puberty Hypoandrogenism Hypoestrogenism Hyperandrogenism Hyperestrogenism Postorgasmic illness syndrome Height Dwarfism / Short stature Midget Laron syndrome Psychosocial Ateliosis Gigantism Multiple Autoimmune polyendocrine syndrome multiple APS1 APS2 Carcinoid syndrome Multiple endocrine neoplasia 2A 2B Progeria Werner syndrome Acrogeria Metageria Woodhouse -- Sakati syndrome Retrieved from `` https://en.wikipedia.org/w/index.php?title=Gigantism&oldid=842415540 '' Categories : Growth disorders Human height Growth hormones Neuroendocrinology People with gigantism Hidden categories : Infobox medical condition All articles lacking reliable references Articles lacking reliable references from July 2015 Talk Contents About Wikipedia Asturianu Беларуская Български Català Čeština Deutsch Eesti Ελληνικά Español Euskara فارسی Français Galego 한국어 Հայերեն Bahasa Indonesia Italiano עברית ქართული Кыргызча مصرى 日本 語 Oʻzbekcha / ўзбекча Polski Português Română Русский Simple English Српски / srpski Srpskohrvatski / српскохрватски Suomi Svenska Türkçe 中文 26 more Edit links This page was last edited on 22 May 2018, at 08 : 57. 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Question: how tall do you need to be to be a giant
Answer: 7 feet