title: Etiologies and clinical presentation of gigantism in Algeria.
abstract: OBJECTIVE
  True gigantism is an exceptional and fascinating pediatric disease. Our aim in this study was to describe the different etiologies of a large group of children with gigantism and the natural history of their growth.
  
  
  METHODS
  In this multicenter study, we considered as giant children, adolescents and adults whose heights were ≥3 SD compared to their target stature or to our population average lengths. Isolated hypogonadism and Klinefelter syndrome were excluded from this series. All underwent clinical exam, and hormonal and neurological investigations.
  
  
  RESULTS
  From 1980 to 2010, we observed 30 giants: 26 males (86.6%) and 4 females (mean age 19.8 ± 11 years). Among the 13 patients (40.3%) who consulted before the age of 16 years, 9 had acromegaly and 6 had mental retardation and body malformations. Based on growth hormone (GH) secretion evaluation, 2 groups were observed: pituitary gigantism (n = 16): GH = 150 ± 252 ng/ml (n ≤ 5), and other causes with normal GH (0.7 ± 0.6 ng/ml): 6 Sotos syndrome and 8 idiopathic cases. Only the first group had neurological, ophthalmological, metabolic and cardiovascular complications and received treatment. The result was not optimal as GH normalization was not observed. Reduction of tumor size and decreased GH plasma values were not observed.
  
  
  CONCLUSIONS
  Gigantism predominates in males. The main cause is GH excess. The diagnosis was very late except for cerebral gigantism. Complications were observed in pituitary gigantism only.
authors.affiliation: Endocrinologie et Maladies Métaboliques, Centre Hospito-Universitaire Bab El Oued, Bologhine, Alger, Algérie. endofarida@hotmail.fr
authors.forename: Farida
authors.initials: F
authors.lastname: Chentli
authors.forename: Said
authors.initials: S
authors.lastname: Azzoug
authors.forename: Mohammed El Amine
authors.initials: Mel A
authors.lastname: Amani
authors.forename: Ali El Mahdi
authors.initials: Ael M
authors.lastname: Haddam
authors.forename: Dalal
authors.initials: D
authors.lastname: Chaouki
authors.forename: Djamila
authors.initials: D
authors.lastname: Meskine
authors.forename: Mohamed Lamine
authors.initials: ML
authors.lastname: Chaouki
mesh_terms: D000172:Acromegaly / Q000150:complications; D000236:Adenoma / Q000150:complications; D000293:Adolescent; D000328:Adult; D000462:Algeria; D002648:Child; D005260:Female; D005877:Gigantism / Q000209:etiology*; D013006:Growth Hormone / Q000097:blood; D006801:Humans; D008297:Male; D010911:Pituitary Neoplasms / Q000150:complications*; D012189:Retrospective Studies; D058495:Sotos Syndrome / Q000209:etiology
chemical_list: D013006:Growth Hormone