An evaluation of seventy-five patients with hypopituitarism beginning in childhood

Brasel, Jo Anne; Wright, James C.; Wilkins, Lawson; Blizzard, Robert M.

doi:10.1016/0002-9343(65)90127-0

Cited by 142 publications

(48 citation statements)

References 40 publications

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“…20 normal children with no apparent thyroid or pituitary disease were studied. This group was comprised of 7 males and 13 females between the ages of 4 and 13 yr. 31 hypopituitary patients selected from our clinic who fulfilled the criteria for diagnosis (13,14) were also studied. Seven of the idiopathic hypopituitary patients also received epinephrine-propranolol infusions during an insulin-arginine tolerance test (EP-AITT), as previously described (15), to ascertain if a correlation could be made between the responses to these stimuli and to TRH.…”

Section: Methodsmentioning

confidence: 99%

Serum Thyrotropin Responses to Synthetic Thyrotropin-Releasing Hormone in Normal Children and Hypopituitary Patients. A NEW TEST TO DISTINGUISH PRIMARY RELEASING HORMONE DEFICIENCY FROM PRIMARY PITUITARY HORMONE DEFICIENCY

Foley¹,

Owings²,

Hayford³

et al. 1972

J. Clin. Invest.

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A B S T R A C T Synthetic thyrotropin-releasing hormone (TRH) was administered intravenously in a dose of 7Ag/kg to 20 normal children ages 4-13 yr. Serum thyroid-stimulating hormone (TSH) was measured by radioimmunoassay and rose from a mean value of 1.7 AU/ml (range = < 1.25-7.2) to a mean peak value of 21.5 ,uU/ml (5.2-33.2) at 15 or 30 min after administration.13 patients with idiopathic hypopituitarism and apparent normal thyroid function, ages 3-19 yr, responded to TRH in a manner very similar to the control subjects: TSH rose from a mean value of 1.8 /AU/ml (range < 1.25-4.3) to a mean peak value of 18.5 AU/ml (range = 9.5-45.0) which occurred between 15 and 60 min after TRH.13 idiopathic hypopituitary patients with documented thyroid deficiency were tested after thyroid therapy had been discontinued for a minimum of 10 days. The serum TSH values in 10 of 13 patients rose from a mean base line level of 2.2 AU/ml ( < 1.25-5.3) to a peak mean value of 32.5 itU/ml (9.6-61.3) between 30 and 120 min after TRH. In three patients, however, little or no TSH response was detected, even when serum thyroxine levels were extremely low. Similar to the latter group, three of five patients with hypopituitarism

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Section: Methodsmentioning

confidence: 99%

Serum Thyrotropin Responses to Synthetic Thyrotropin-Releasing Hormone in Normal Children and Hypopituitary Patients. A NEW TEST TO DISTINGUISH PRIMARY RELEASING HORMONE DEFICIENCY FROM PRIMARY PITUITARY HORMONE DEFICIENCY

Foley¹,

Owings²,

Hayford³

et al. 1972

J. Clin. Invest.

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“…Even though patients with gynecomastia, hypoandrogenization, and low gonadotropin excretion may have a primary defect of gonadotropin production, increased blood estrogens could also produce these same clinical and laboratory findings (29); a clomiphene stimulation test should be useful in this distinction. To further add to the heterogeneity of these syndromes, primary hypogonadism has also been described in patients with Laurence-Moon-.Biedl syndrome (29) and familial ataxia (30 (31,32). These features include eunuchoidal body proportions, delayed bone age, small soft testes, and decreased development of androgen-dependent tissues and organs.…”

Section: Methodsmentioning

confidence: 99%

Studies of the pituitary-Leydig cell axis in young men with hypogonadotropic hypogonadism and hyposmia: comparison with normal men, prepuberal boys, and hypopituitary patients

Bardin¹,

Ross²,

Rifkind³

et al. 1969

J. Clin. Invest.

164

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A B S T R A C T Pituitary and gonadal function was studied in seven chromatin-negative men, ages 15-27 yr, with retarded sexual and somatic development, skeletal anomalies, and hyposnmia. These hyposmic patients were compared with normal men, prepuberal boys and hypogonadal patients with hypopituitarism. The urinary follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels of hyposmic subjects were the same as those of normal boys and hypopituitary patients but significantly lower than those of normal men. Clomiphene citrate did not cause an increase in plasma FSH and LH levels in either hypogonadal group as it does in normal men. In contrast to hypopituitary patients, thyroid and adrenocortical function and release of growth hormone in the hyposmic subjects were normal. The plasma testosterone levels were equally low in prepuberal, hypopituitary, and hyposmic patients but were increased to a greater extent by human chorionic gonadotropin (HCG) treatment in prepuberal and hypopituitary subjects than in the hyposmic patients. Prolonged treatment with HCG has failed to return plasma testosterone levels to normal in two hyposmic patients. These observations suggest that there are defects of both pituitary and Leydig cell function in men with the syndrome of hypogonadism, skeletal anomalies, and hyposmia. They have impaired secretion of FSH and LH and a Leydig cell insensitivity to gonadotropin.

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“…A critérium of mean increment calculated on a log scale has been used by Brownie and Sprunt (6). A fifth critérium is that of a minimum for the highest daily excretion independent of the basal level (1,4,18,36). A common basic critérium is that of normal basal excretion (> b in fig.…”

Section: Discussionmentioning

confidence: 99%

Critical Evaluation of the 5-Day Metyrapone Test

Leisti¹,

Perheentupa²

1977

Horm Res

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Different parameters of the response to the 5-day metyrapone test were evaluated for their diagnostic accuracy in tests given to 58 children and adolescents as part of an investigation for short stature. Insulin test, vasopressin test and ACTH test were used for diagnostic reference. A log transformation of the data was clearly appropriate. The maximal daily excretion of 17-ketogenic steroids was distinctly positively correlated with the basal excretion. Consequently, the most correct parameter of the response is the SD score of the deviation of the maximal excretion from the regression of the maximal excretion on the basal excretion in the reference population. This parameter, ‘relative maximal excretion’ was shown to be the diagnostically most accurate index of the response of 11 parameters studied.

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An evaluation of seventy-five patients with hypopituitarism beginning in childhood

Cited by 142 publications

References 40 publications

Serum Thyrotropin Responses to Synthetic Thyrotropin-Releasing Hormone in Normal Children and Hypopituitary Patients. A NEW TEST TO DISTINGUISH PRIMARY RELEASING HORMONE DEFICIENCY FROM PRIMARY PITUITARY HORMONE DEFICIENCY

Serum Thyrotropin Responses to Synthetic Thyrotropin-Releasing Hormone in Normal Children and Hypopituitary Patients. A NEW TEST TO DISTINGUISH PRIMARY RELEASING HORMONE DEFICIENCY FROM PRIMARY PITUITARY HORMONE DEFICIENCY

Studies of the pituitary-Leydig cell axis in young men with hypogonadotropic hypogonadism and hyposmia: comparison with normal men, prepuberal boys, and hypopituitary patients

Critical Evaluation of the 5-Day Metyrapone Test

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