This study shows that a low dose of biosynthetic growth hormone can elevate IGF-I levels and have a pronounced physical impact in the growth hormone deficient adult without the side-effects seen at higher dosage schedules. Over a 2 month period the increase in fat-free mass may be due to an increase in total body water; however, the decline in fat mass is a genuine effect.

Patients treated for pituitary tumour, excepting those treated with transfrontal surgery and to a lesser extent those treated with radiotherapy, suffer from mild mood disturbance and self-perceived decreased social adjustment. All patient groups are seen by others as having decreased social adjustment, raising the possibility that the transfrontal patients and possibly those who have had radiotherapy, lack insight. This may explain some of the discrepancies in the previous literature and needs to be taken into account when using self-report measures with these patients.

We studied the effect of age on the relationship between haemoglobin and serum erythropoietin (EPO) levels in anaemic patients. 568 patients over 70 years of age were compared with 137 patients under 70 and a reference group of 144 patients of all ages with proven iron deficiency. EPO was measured using a radioimmunoassay. We found that elderly patients with a normocytic anaemia (N = 375) had a statistically lower EPO response than younger patients with normocytic anaemia (N = 61) (p < 0.05) or patients of all ages with iron‐deficiency anaemia (p < 0.05). There was no difference between the sexes. Elderly patients with microcytic or macrocytic anaemia had a normal EPO response as compared to the “gold standard” of iron deficiency. These findings suggest that a proportion of elderly patients with normocytic anaemia has an impaired EPO response.

Summary Paragangliomas are neuroendocrine tumours and those occurring in the head and neck have well recognized familial association. Retroperitoneal paragangliomas are uncommon and we present two cases of familial malignant retroperitoneal paraganglioma. Review of the literature revealed marked differences in the incidence and malignant potential of familial and non-familial paraganglioma. In contrast to the cases reported here, familial tumours are generally benign, though they may occur at multiple sites. Familial and non-familial paragangliomas may indeed be different disease entities.

Mild alterations in serum magnesium are said to be symptomless (D. N. S. Kerr in Cecil and Loeb, 1971). Cade (1964) reported high levels in depression but Frizelet al.(1969) found low values restored to normal with clinical recovery. Raised serum magnesium concentrations have been reported in manic patients (Nielson, 1964; Goodwin, Murphy and Bunney, 1968) and schizophrenics (Cade, 1964). These results suggested that serum magnesium had predictive value in the treatment of psychiatric patients, so we estimated pre- and post-treatment serum magnesium concentrations in a number of patients and investigated their relationships with diagnosis and clinical course.