A possible case of Gigantism and/or Acromegaly in a 15th-17th century woman from Đurine Ćelije, Serbia
Abstract and Figures
Endocrine disorders during growth and development that occur due to the secretion of excessive growth hormones are very rare in archaeological and modern populations. The human skeletal remains analyzed in this paper belong to an unusually tall woman, approximately 35-40 years of age, buried at the Đurine ćelije site (15th-17th century) in Serbia, who may have suffered from overgrowth syndrome. Individuals with this condition have an unusually tall stature and accompanying pathological changes related to organ systems and joint diseases. The aim of this paper is to show how the aforementioned disorder affected the health status of an individual (grave No. 7a) and the performance of daily activities, but also the attitude of the community towards deformities in the life of that same person and after death. Differential diagnosis was performed since other diseases tend to lead to similar health problems. During the analysis, changes in growth were noticed, and her stature was determined to be 186.42 cm. Compared to the documented stature of the medieval population from this period, the skeletal remains show a significant deviation from the average, especially when it comes to female individuals. Other pathological changes observed in this woman are osteoarthritis, spondyloarthropathy, and periosteal new bone formation.
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... The bioanthropological analysis of osteological material was performed by the first author of this paper, as part of the master's thesis (Miljević 2018) and the remaining part as a bioantropological report (2019) for the National Museum Aranđelovac. Except for one separate grave unit (Miljević-Đajić 2021), the results of bioanthropological analysis of the skeletal remains haven't been published. restoration of the Serbian Patriarchate of Peć in 1557 (Радичевић и Миливојевић 2013, 82-90; Радичевић и др. ...
This paper presents the results of a bioanthropological analysis of human skeletal
remains from grave no. 34 from the site of Đurine Ćelije on Rudnik. The remains of
a small late medieval monastery, from the beginning of the 15th century until the end of
the 17th century, were discovered and systematically researched. The monastery was destroyed
and rebuilt in the time of the Turks and later abandoned. The burial of a deceased
in grave no. 34 was performed in the second half of the 16th or during the 17th century. The
deceased most likely belonged to the brotherhood of this monastery. A specific disease
caused by the bacillus Mycobacterium tuberculosis was detected in the skeletal remains
of this man. Pathological changes coexisting with this disease were present on the endocranial
surface of the skull, and the thoracic vertebrae, and destructive lesions were
detected on the ribs, shoulder joints, and sacroiliac joint.
Folia Morphol.
Vol. 74, No. 2, pp. 219–224
DOI: 10.5603/FM.2015.0034
Copyright © 2015 Via Medica
ISSN 0015–5659
www.fm.viamedica.pl
Many theories have been suggested in order to explain the aetiology of septal
aperture. The influence of genes, the size and shape of ulna processes, joint laxity,
bone robusticity, osteoarthritis, and osteoporosis has been discussed; however,
the problem has not yet been solved. The aim of the study was to examine the
correlations between musculoskeletal stress markers, humeral robusticity and
septal aperture. Additionally, the frequency of septal aperture according to sex,
age, and skeletal side had been analysed. The skeletal material had come from
a medieval cemetery in Cedynia, Poland. Skeletons of 201 adults (102 males, 99
females) had been examined and septal aperture had been scored. Six muscle
attachment sites of upper limb bones had been analysed. Humeral robusticity had
been calculated by use of the humeral robusticity index. The frequency of septal
aperture among the population from Cedynia is 7.5%. There are no differences
in septal aperture prevalence between males and females, the skeletal sides or
age groups. In the analysed material, males with less developed muscle markers
of right upper bones proved a higher predictable rate in having septal aperture
(R = –0.34). On the left bones and among females, the converse correlation had
also been found, but it is not statistically significant. The correlation between
septal aperture and humeral robusticity is converse, yet small and insignificant.
These results can confirm the theory of joint laxity and suggest that stronger bones
(heavier muscles, more robust bones) increase joint tightness, and therefore
protect the humeral lamina from septal aperture formation. But this theory needs
a further detailed analysis.
Many theories have been suggested in order to explain the etiology of septal aperture (SA), however
the problem has not been solved yet. The aim of the study was to examine the relationship
between septal aperture and osteoarthritic changes. The skeletal material had come from a medieval
cemetery in Cedynia, Poland. Skeletons of 201 adults had been examined. Septal aperture of
humeral bone had been scored. Osteoarthritic changes (osteophytosis, porosity, eburnation) of
articular surfaces of distal end of humerus and proximal end of ulna had been examined. In the
present study female right bones with septal aperture were predicted to have porosity of articular
surfaces of elbow joint (R = 0.30). But the caution is required when interpreting this result. Firstly,
significant correlation was observed in the females’ right bones only. Secondly, the etiology of porosity
is not clear. Septal aperture did not correlate with osteophytosis, and eburnation (correlation
is low and negative). This result contradicts the mechanical theory of SA formation (SA is a
result of the impingement of overgrown ulnar process on the humeral septum). One explanation
can be that osteophytes limit the natural motion of the joint to constitute a repair response an attempt
at stabilizing the degenerating joint. It can prevent from septal aperture formation, or/and
its enlargement. As in the case of osteophytes, eburnation limits elbow mobility, and thereby can
exclude septal aperture formation. Further analyses of the relationship between septal aperture
and osteoarthritic changes formation are needed. It is important for anthropological, and medical
researches.
Pituitary gigantism is a rare endocrine disorder caused by hypersecretion of growth hormone during growing period. Individuals with this disorder have an enormous growth in height and associated degenerative changes. The continued hypersecretion of growth hormone during adulthood leads
to acromegaly, a condition related to the disproportionate bone growth of the skull, hands and feet. The skeletal remains studied belong to a young adult male from the Jewish necropolis of “Ronda Sur” in Lucena (Ćordoba, Spain, VIII–XII centuries CE). The individual
shows a very large and thick neurocranium, pronounced supraorbital ridges, an extremely prominent occipital protuberance, and an extremely large and massive mandible. Additional pathologies include enlargement of the vertebral bodies with degenerative changes, thickened ribs, and a slight
increased length of the diaphysis with an increased cortical bone thickness of lower limbs. Comparative metric analysis of the mandible with other individuals from the same population and a contemporary Mediterranean population shows a trend toward acromegalic morphology. This case is an important
contribution in paleopathological literature because it is a rare condition that has not been widely documented in ancient skeletal remains.
In 2003, a tall skeleton belonging to a young adult individual was recovered from a post-medieval cemetery situated NE of the modern city of Erzurum, Turkey. The sex of the individual was not possible to determine. The predicted stature values range from 182 cm to 200 cm with the average 188.94 cm. The growth was proportional on almost all bones, except for the cranial and facial bones. The selected metric data were compared with the mean values of the male individuals from the same cemetery for differential diagnosis. The individual exhibits characteristics of both pituitary gigantism and acromegaly due to the tumor formation developed in the intrasellar area. Pathological features such as severe osteoarthritis, enthesis, and new bone formation around and on the joint surface of the post-cranial bones, kyphoscoliosis, and ankyloses are in agreement with these diagnoses as well.
This chapter uses the osteobiographies of two women from different sites in medieval Poland (Kałdus, twelfth to the first half of the thirteenth century and Ostrów Lednicki, the end of the twelfth and the beginning of the fourteenth century), in combination with analysis of mortuary practice, to consider individual experiences of pathology and possible receipt of care. The first individual described in this study is a female recovered from the Kałdus site, who displays pathological lesions indicating an advanced stage of (possibly lepromatous) leprosy. The location of her grave and the associated grave goods suggest that this individual, despite disfiguring disease, received mortuary treatment associated with those of a higher social status. The second individual is a ‘giant’ probably woman with an estimated stature of 215.5 cm, whose skeleton was discovered in the cemetery on the Ostrów Lednicki island. Osteomas of femur, extensive degenerative joint disease, probably healed fracture of the tibia and Harris’ lines were identified on her skeleton. Her remains did not receive a standard burial, but rather appear to have been deposited without care, which may suggest she was perceived as ‘different’ in death and may have been subject to different treatment by her community during her lifetime. The Index of Care (Tilley and Cameron, International Journal of Paleopathology 6:5–9, 2014) is employed in assessing the likely impacts of disease and associated care requirements for these two very distinctive women, and the conclusions drawn from this process, combined with those of the respective mortuary analyses, form the basis for developing a deeper understanding of these subjects’ contrasting social identities.
http://www.springer.com/la/book/9783319399003
Gigantism is a serious condition, manifesting itself not only in excessive body height, but also in disturbances within other systems [e.g. respiratory, nervous and vascular system (Hayles 1980)] since it is caused by excessive secretion of the pituitary hormone somatotrophin, most frequently in connection with an acidophil adenoma developed in childhood. A skeleton, likely female, excavated from an early medieval cemetery of Ostrów Lednicki in Lednogóra, dated between the end of 11th and the beginning of the 14th century A.D., is presented. The length of the skeleton in situ was 208 cm, and after Trotter, Gleser's -215,5 cm. Morphological, radiological and TC investigations show that the bones are massive, particularly the skull. Lesions are apparent in many bones, especially in the skull and vertebrae. These are lesions characteristic of gigantism: acromegaly, osteoma, inflammatory process, fracture, degenerative deformations, extensive loading and some developmental deviations. Apart from a thorough description and measurements of the case, a short outline of hitherto described cases of gigantism is presented.
This reference work is an attempt to provide an integrated and reasonably comprehensive treatnient of pathological conditions that affect the human skeleton. The primary objective is to assist those who conduct research on archeological skeletal remains in interpreting abnormal conditions that they might encounter in the course of their research. However, there is much that ancient skeletal remains can reveal to the modern medical historian, orthopaedist, pathologist, and radiologist about skeletal diseases that are rarely encountered in modern clinical practice. All of the major categories of disease that affect bone are reviewed from the viewpoint of the pathologist. This review is followed by a discussion of the literature on the paleopathology of each condition and the presentation of paleopathological cases thought to represent each of the morbid categories affecting bone. This work is based on extensive individual and collaborative research by both authors on the known parameters of modern skeletal diseases and their expression in antiquity. The monograph provides essential text and illustrative materials on bone pathology, which will improve the diagnostic ability of those interested in human dry bone pathology.
Pierre Marie coined the term 'acromegaly' in 1886 and linked this to a distinct clinical disease with a characteristic clinical picture. However, Pierre Marie was not the first physician to give a full record of the clinical picture of acromegaly, but others had preceded him, like the Dutch physician Johannes Wier. After Marie, pituitary enlargement was noted in almost all patients with acromegaly. Subsequently it was discovered that pituitary hyperfunction caused by a pituitary tumour was indeed the cause of acromegaly. The cause of acromegaly could be further determined after the discovery of growth hormone (GH) and insulin-like growth factor I (IGF-I) and demonstrating an association with GH hypersecretion and elevated circulating IGF-I. From the beginning of the 20th century, acromegaly could be treated by pituitary surgery and/or radiotherapy. After 1970, medical therapies were introduced that could control acromegaly. First, dopamine agonists were introduced, followed by somatostatin analogues and GH-receptor blockers. © 2015 S. Karger AG, Basel.
A skeleton excavated from the Blossom Mound (CA-SJO-68), a Late Holocene (4350–2980 BP) site located in the northern San Joaquin Valley of California, exhibits evidence of unusual craniofacial and postcranial features consistent with endocrine disease. Burial 37, an adult male approximately 30–40 years of age, shows pronounced development of the mental eminence, glabellar region, and supraorbital arches, as well as elongation of the mandibular ramus, crowding and malocclusion of the anterior dentition, and periosteal bone formation at several enthesis sites. In addition, abnormal enlargement of the sella turcica as well as pneumatization of the frontal and maxillary sinus and mastoid air cells was observed.
These skeletal characteristics are consistent with a diagnosis of acromegaly, an endocrine disorder characterized by the enlargement of bone and soft tissue resulting from a pituitary gland tumor that increases the secretion of growth hormone. Onset typically occurs after epiphyseal fusion, a characteristic that distinguishes it from gigantism. This case study utilizes current clinical criteria for diagnosing acromegaly in human skeletal remains and discusses other evidence of this rare condition in the archeological record.