Combined test for hypothalamic/pituitary function in growth retarded children, treated with hurian growth hormone (HGH)

Abstract

Among 23 growth retarded children, 9 showed a lack of growth hormone (GH) response and 14 an intermediary response to insulin tolerance test (ITT). After HGH treatment for 42 months (mean) all were retested with a combined pituitary stimulation test(ITT + TRH + LHRH) with estimation of GH, somatomedin (SM), ACTH, TSH, prolactin (PRL), LH and FSH. The 9 formerly GH-non responders showed a permanent GH deficiency (group I), while 10 of the previously GH-intermediary responders now had a normal GH response (group II) and 4 still had intermediary response (group III). In group I SM was low, the ACTH response subnormal, the TSH and PRL response prolonged and in prepubertal children deficient LH and FSH response was found, whereas these parameters with few exceptions all were normal in group II and III. This indicates: 1) Lack of GH response is a persistent condition often accompanied by hypothalamic dysfunction with abnormal secretion of other anterior pituitary hormones. 2) Intermediary GH response may be transient and associated with normal secretion of anterior pituitary hormones.