Serum Follicular-Stimulating Hormone and Luteinizing Hormone as Measured by Radioimmunoassay Correlated with Sexual Development in Hypopituitary Subjects

Abstract

A B S T R A C T Serum follicular-stimulating hormone (FSH) and luteinizing hormone (LH) as determined by radioimmunoassay, were correlated with sexual development in 29 patients with hypopituitarism (ages 14.2-29.9 yr).16 of 25 idiopathic hypopituitary patients (20 males and 5 females) exhibited some degree of sexual development. Stage TII of sexual development or beyond was achieved by 12 of the 16. Of 13 patients with growth hormone (GH), adrenocortical-stimulating hormone (ACTH), and thyroid-stimulating hormone (TSH) deficiency, 8 did not develop beyond stage I. In contrast, five of six patients with GH deficiency without ACTH or TSH deficiency developed to stage III of sexual development or beyond. The mean (+SD) serum LH concentration while in stage I (4.3 ±0.9 mIU/ml) of eight patients (seven males and one female) who developed beyond stage I was significantly (P < 0.005) greater than the mean serum LH concentration (2.3 ±0.9 mIU/ml) in nine patients (seven males and two females) who had not developed beyond stage T. Mean serum FSH concentrations were not different.Three of four males with organic hypopituitarism did not develop beyond stage I of sexual development.Serum FSH and LH concentrations in the idiopathic and organic hypopituitary patients were more compatible with stage of sexual development than with age. A serum LH concentration below the range of normal for stage I of sexual development in a prepubertal patient

Stunted growth with more or less normal appearance

“…The gonadotropins--without stimulation and after LHRH --are also more correlated with bone age and maturation than with chronological age [115,120,191,239,254]. Certainly one has to agree with Wilkins' concept that the late beginning of gonadotropin secretion and puberty is a secondary phenomenon.…”

GnRH and HCG Tests Are Both Necessary in Differential Diagnosis of Male Delayed Puberty

“…Broken hori¬ zontal line Indicates upper limit of pre¬ pubertal testis size.17 groups were compared at the same penis stage. The length and width of each testis was measured for mean testis volume.18 Penis and pubic hair development were staged.1930, 60, 90, and 120 minutes. The maximal levels, the maximal increments above the basal levels (ALH and AFSH), and the integrated response areas above the basal levels for LH and FSH and above zero level for LH and FSH were evaluated.For the HCG test, chorionic gonado¬ tropin (Pregnyl) was given by four in¬ tramuscular injections of 5,000 IU/sq m each on days 1, 3, 8, and 10.…”