From the Guidelines
Gigantism in females is diagnosed at a height of +2 or +3 SDS above the country-specific, age-appropriate and sex-appropriate mean height or +2 SDS above the mid-parental height 1.
Diagnostic Criteria
The diagnostic criteria for gigantism include:
- Accelerated growth velocity >+2 SDS
- Abnormally tall stature defined as +2 or +3 SDS above the country-specific, age-appropriate and sex-appropriate mean height or +2 SDS above the mid-parental height 1
Important Considerations
It is essential to note that the definition of pituitary gigantism is arbitrary 1, and the diagnosis should be made based on a combination of clinical, laboratory, and imaging findings.
Epidemiology
Gigantism is a rare condition, with an estimated annual incidence rate of 3-8 cases per million person-years among children aged 0-17 years old 1. While there are more male patients with gigantism overall, more girls (62%) than boys are diagnosed with gigantism in the CYP age group 1.
From the Research
Diagnostic Criteria for Gigantism in Females
The diagnostic criteria for gigantism in females are not explicitly stated in terms of a specific height. However, the following points can be considered:
- Tall stature is defined as height greater than 2 standard deviations above the average population height for age, sex, and ethnicity 2, 3.
- Pituitary gigantism is a rare disease characterized by chronic growth hormone and insulin-like growth factor 1 secretion from a pituitary somatotrope adenoma that forms before the closure of the epiphyses 4.
- The final height of patients with pituitary gigantism can be extremely elevated if left untreated or poorly managed 4, 5.
Height Considerations
Some studies provide insight into the heights of females with gigantism:
- A case report describes an 11-year-old female with gigantism who had a height of 181 cm 6.
- A study of 208 patients with pituitary gigantism, including 45 females, found that the final height was greater in younger onset patients, with larger tumors and higher GH levels 5.
- However, these studies do not provide a specific height threshold for diagnosing gigantism in females.
Key Points
- The diagnosis of gigantism in females should be based on a comprehensive evaluation, including medical history, physical examination, and laboratory tests 2, 3.
- The presence of a pituitary adenoma and elevated growth hormone and insulin-like growth factor 1 levels are key diagnostic features of pituitary gigantism 4, 5.
- Early diagnosis and treatment are crucial to prevent excessive growth and improve outcomes in patients with pituitary gigantism 4, 5.