CHARACTERISTIC FEATURES
1. Head & face: “Ape-like face”
∙ Big skull with elongated face.
∙ Big ears, Big nose, Big lips, Big tongue.
∙ Prognathism + separation of the teeth.
∙ Prominent frontal bosses & prominent supraprbital ridges.
2. Hands: “ Spade-like hands”
∙ Big hands with blunt fingers.
3. Skeletal affection:
∙ Osteoarthritis may occur: features of arthritis + crepitus in the knee.
4. Skin affection:
∙ Thick, wrinkled, greasy.
5. Organ enlargement:
∙ Hepatosplenomegaly.
∙ Heart enlargement (with Cardiomyopathy) → HF.
∙ Hypertrophy of the wall of the blood vessels → Hypertension.
∙ Hypertrophy of the larynx → Hoarseness of voice.
6. Associated endocrinal disturbances:
∙ Diabetes mellitus: may occur in 30 % of the cases.
∙ Galactorrhea: may occur.
7. Muscle affection:
∙ Early: increased muscle power.
∙ Late: decreased muscle power & MYOPATHY.
B) NEUROLOGICAL MANIFESTATIONS
∙ Peripheral neuropathy: GLOVE & STOCKING HYPOSTHESIA.
∙ Parasthesias in hands & feet may occur due to:
- Peripheral neuropathy.
- Diabetic neuropathy.
- Carpal tunnel syndrome.
∙ Pressure manifestations:
- Hypothalamic syndrome, Bitemporal hemianopia.
