Hypothalamic-Pituitary Function in Patients with Craniopharyngiomas

Jenkins, J. S.; Gilbert, Colleen; Ang, V. T. Y.

doi:10.1210/jcem-43-2-394

Cited by 86 publications

(14 citation statements)

References 18 publications

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“…In this study, all IGHD patients were of euthyroid state, but they showed delayed TSH responses to TRH as was seen also in 2ry GHD patients. This may indicate that IGHD patients have subclinical lesions in hypothalamic TRH neurons (Jenkins et al 1976 ;Okada et al 1978). Plasma PRL responses to TRH were also significantly delayed in IGHD and 2ry GHD patients.…”

Section: Discussionmentioning

confidence: 93%

GHRH and TRH tests in patients with idiopathic and secondary GH deficiency. With special reference to GH response patterns to GHRH.

Hanew

Sugawara

Utsumi

et al. 1990

Tohoku J. Exp. Med.

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Tests in Patients with Idiopathic and Secondary GH Deficiency -With Special Reference to OH Response Patterns to GHRH . Tohoku J. Exp. Med., 1990, 160 (3), [189][190][191][192][193][194][195][196][197][198][199][200][201][202] To study whether patients with idiopathic GH deficiency (IGHD) show a delayed GH response pattern to GHRH, 42 patients with IGHD, 14 patients with hypothalamic tumor (try GHD), and 23 normal short children (NSC) were examined as to their GH response patterns to GHRH together with their TSH and PRL response patterns to TRH. After TRH injection, the mean time of the TSH peak in IGHD (67.5 + 6.5 min, n = 36) and try GHD patients (81.7± 14.8 min, n = 9) was clearly delayed comparing to that of NSC (29.1 + 2.9 min, n =16 ; both p <0.01). Similarly, the mean time of the PRL peak in IGHD (38.3 + 3.6 min, n = 36) and try GHD patients (39.5 + 5.8, n =11) was significantly delayed comparing to NSC (22.0+3.5 min, both p <0.01). In IGHD patients, the delayed response pattern of TSH and PRL was more remarkable in patients who had breech delivery than in those with normal delivery. In contrast, the mean time of the GH peak was similar in I GHD (62.1±4.0 min, n =41), try GHD (64.1± 8.1 min, n =11) and NSC (58.0± 6.1 min, n =23). However, the decline from peak GH (120 min GH/peak GH) was significantly smaller in IGHD (54.3+ 4.2%) and try GHD (60.7+7.3%) than in NSC (39.0+8.1%) (both p<0.05). Further, in IGHD patients plasma GH response was greater in patients with normal delivery than in those with breech and asphyxia delivery. These results seem to indicate : 1) the stimulus-secretion mechanism is different between somatotrophs and thyrotrophs or lactotrophs in man, 2) IGHD patients have hypothalamic lesions as well as pituitary lesions, 3) such hypothalamo-pituitary lesions in IGHD patients are greater in patients with abnormal delivery than in those with normal delivery, idiopathic GH deficiency ; GHRH ; TRH ; GII ; TSH It is known that patients with hypothalamic lesions and idiopathic growth hormone deficiency (IGHD) often show delayed TSH responses to TRH adminis-

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Section: Discussionmentioning

confidence: 93%

GHRH and TRH tests in patients with idiopathic and secondary GH deficiency. With special reference to GH response patterns to GHRH.

Hanew

Sugawara

Utsumi

et al. 1990

Tohoku J. Exp. Med.

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“…Exaggerated and/or delayed TSH responses have been interpreted as being suggestive of hypothalamic lesions in several previous studies in both adults and children [4,5,6,7,8]. However, other authors have questioned the specificity of exaggerated and/or delayed TSH responses for hypothalamic lesions and have pointed out the often artificial distinction between pituitary and hypothalamic disease [10, 13, 22,26,27,28]. In particular, a delayed TSH response has been described in a patient with a mutation of the pituitary-specific transcription factor PIT1 in whom there was no evidence of hypothalamic dysfunction [29].…”

Section: Discussionmentioning

confidence: 99%

An Evaluation of the Thyrotrophin-Releasing Hormone Stimulation Test in Paediatric Clinical Practice

Crofton

Tepper²,

Kelnar³

2007

Horm Res Paediatr

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Aim: The aim of this retrospective study was to evaluate the clinical usefulness of the thyrotropin-releasing hormone (TRH) test in children with suspected hypothalamic or pituitary dysfunction. Methods: We reviewed the case notes of all patients in whom a TRH test had been performed over a 6-year period. Group 1 (n = 85, 34 males, aged 0.9–18.8 years) was the reference group with no evidence of hypothalamic, pituitary or thyroid dysfunction. Group 2 (n = 42, 24 males, 0.1–18.0 years) were being investigated for possible pituitary or hypothalamic insufficiency. Results: In Group 1, thyrotropin (TSH) responses were higher in females than males (p < 0.01). In Group 2, TSH responses were normal for gender in 26 patients, subnormal in 5, and exaggerated/delayed in 11. Four patients with normal TSH responses and 4 with exaggerated/delayed responses had persistently low free thyroxine (FT₄) or later developed low FT₄ and were treated with thyroxine. All those with subnormal TSH responses had normal FT₄ and were not treated. The TRH test did not reliably discriminate between hypothalamic and pituitary disorders. Conclusions: The TRH test did not give useful clinical information. Clinical decisions regarding thyroxine treatment were based on FT₄, not the TRH test. The TRH test should be abandoned in paediatric practice.

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“…As illustrated by our findings, this is especially true in the de tection of STH and ACTH insufficiency. Recently developed tests of response to hypothalamic releasing factors are very useful in distinguishing anterior pituitary from hypothalamic dysfunction [4,7,17].…”

Section: Discussionmentioning

confidence: 99%

Parasellar Tumors in Children

Richmond¹,

Wilson²

1980

Pediatr Neurosurg

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This paper reviews the clinical presentation, neuro-ophthalmologic, endocrinologic, and radiographic findings of 74 children (0–20 years) harboring parasellar lesions who were treated on our service between 1968 and 1977. Our data support the conclusion that earlier diagnosis is occurring, although there is still a significant lag between onset of symptoms and treatment, especially in histologically benign lesions. The differential diagnosis is facilitated by recognition of key features of four major tumor types: craniopharyngioma, parasellar glioma, germinoma, and pituitary adenoma.

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Hypothalamic-Pituitary Function in Patients with Craniopharyngiomas

Cited by 86 publications

References 18 publications

GHRH and TRH tests in patients with idiopathic and secondary GH deficiency. With special reference to GH response patterns to GHRH.

GHRH and TRH tests in patients with idiopathic and secondary GH deficiency. With special reference to GH response patterns to GHRH.

An Evaluation of the Thyrotrophin-Releasing Hormone Stimulation Test in Paediatric Clinical Practice

Parasellar Tumors in Children

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