Growth hormone response to thyrotropin releasing hormone in a pellagrin.

Abstract

An abnormal hyperresponse of GH to intravenous injection of TRH in a 66-year-old female pellagra patient with typical 3'D's was reported. Diagnosis of pellagra was mainly based on her clinical course and manifestations, although serum levels of nicotinic acid and serotonin were within the normal range. Serum vitamin A and B2 levels were low. However, these findings did not exclude the diagnosis. The abnormal GH response to TRH observed in this patient was decreased at 2 months and thoroughly disappeared at 10 months after admission. GH response to arginine showed an exaggerated and sustained response on admission, decreased at 2 months and showed an almost normal pattern at 10 months after admission. TSH and prolactin response to TRH were normal throughout the clinical course. LH and FSH response to LH-RH were exaggerated, suggesting post-menopausal hypogonadism. Cortisol response to ACTH showed slightly sustained reactions at both times of the provocation.Oral glucose tolerance test revealed a slight impairment in this patient. These results suggest that pellagra is one of the disorders which exhibit an abnormal hyperresponse of GH to intravenous administration of TRH.

Paradoxical Prolactin Response to Growth Hormone-Releasing Hormone in a Patient with Hyperprolactinemia and Empty Sella.

“…In general, paradoxical response of pituitary hormones to hypothalamic releasing hormones has been documented in pituitary adenomas; GH to TRH [5] or LHRH [6,7] and PRL to GHRH in acromegaly [1], ACTH to LHRH in Cushing's disease [8], LH or FSH to TRH in gonadotropin secreting adenoma [9] and in systemic diseases; GH to TRH in chronic liver disease, chronic renal failure, IDDM, pellagrin [ 10], depression [11] and anorexia nervosa [ 12]. The present case represents no acromegalic features, no pituitary disease listed above or systemic disease.…”