Surprised, the woman acknowledged that her wedding ring no longer fit. Lesser askedĪbout changes in her ring size. Lesser asked the patient, “Have you always had such deep-set eyes?” But she hadn’t noticed any changes in her eyes. She also didn’t wear any rings on her fingers, even though she was married.Īfter introducing himself, Dr. He also noted that hisĥ-foot-2-inch patient had large hands for such a petite woman. Lesser entered the exam room, he was struck by the patient’s deep-set eyes. Robert Lesser, a neuro-ophthalmologist in Southbury, Conn. Many of theseĮffects will be reversed once the disease is treated. With untreated acromegaly often develop diabetes, hypertension and sleep apnea and may die at a younger age, usually from cardiovascular disease or certain cancers, most frequently colon cancer.
Internal organs, particularly the thyroid, can also be affected. Tunnel syndrome is common as a result of swelling of the tissues surrounding the median nerve as it passes through the wrist to the hand. Adult-onset acromegaly will cause an increase in the soft tissues of the face, hands and feet. Once bones mature, excess growth hormone will not cause an increase in height, but other tissues will enlarge. Their distinctiveįaces reveal some of the characteristic acromegalic changes: Their brows are prominent, and they have wide, square chins and large noses. Richard Kiel, the 7-foot-2 actor who played the villain Jaws in two James Bond movies, both had acromegaly from childhood. André the Giant, the French professional wrestler and actor whose height was billed at 7 feet 4 inches, Children with acromegaly can grow toĮxtraordinary stature. Well done!Īcromegaly is a disease caused by a tumor, usually found in the pituitary gland, that secretes an excess of growth hormone, the blood chemical that tells our bodies to grow. In all, 16 readers figured out the correct diagnosis.
A few other readers also guessed both the questions and the diagnosis, but Dr. Gierke also guessed one of the questions that the diagnosing physician asked the patient - “Has your shoe size changed recently?”. He said he recognized the condition because he had a patient who had acromegaly and only a few very Eric Gierke, a neurologist at Swedish Medical Center in Seattle.
The first reader to figure it out completely was Dr. Nearly 500 readers submitted their thinking on the case after viewing a photograph of the patient.Īnd the questions the doctor asked the patient were… Her a few simple questions that confirmed his diagnostic suspicions. The case was surprising because the woman didn’t feel sick, yet the doctor made the diagnosis just by looking at her and asking Woman who learned she had an unusual disease after visiting an ophthalmologist. On Thursday I challenged Well readers to figure out a medical mystery involving a middle-aged
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