Abstract
Fifty three patients with idiopathic (45) and organic (8) hypopituitarism, 43 boys and 10 girls, were studied during treatment with hGH. The gonadotrophin responses to GnRH (25 μg/m2) and serum levels of DHEA-s were measured yearly ; 15 patients remained prepubertal whereas 38 patients were studied before and during puberty occuring either spontaneously (11) or induced (27) by testosterone propionate (100 mg/mth) or ethinyloestradiol (10 μg/day) Gonadarche and adrenarche were dissociated in some patients : among the 11 patients with spontaneous gonadarche, 2 had no previous biological adrenarche ; among the 27 gonadotrophin deficient (G.D.) patients, 9 had spontaneous adrenarche. In prepubertal patients who were subsequently confirmed to be G.D., 27 GnRH tests were performed ; 23/27 integrated responses (I.R.) of FSH were found to be markedly lower than those observed in prepubertal controls of both sexes. In 9/27, I.R. of LH were below the control range. However, when in boys, I.R. of LH were analyzed according to bone age, 17/19 were below the lower limit of the control range. These data might stress the importance of calculating I.R. of FSH to GnRH in hypopituitary patients in order to predict gonadotrophin deficiency.
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