Stimulation of Growth Hormone Secretion by Levodopa-Peopranolol in Children and Adolescents

PEDIATRICS ◽  
1975 ◽  
Vol 56 (2) ◽  
pp. 262-266
Author(s):  
Robert Collu ◽  
Gilles Leboeuf ◽  
Jacques Letarte ◽  
Jacques R. Ducharme
Keyword(s):  
Growth Hormone ◽  
Short Stature ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Hormone Deficiency ◽  
Primary Amenorrhea ◽  
Provocative Test ◽  
Insulin Tolerance ◽  
Chromophobe Adenoma ◽  
The Mean

Levodopa, 0.5 gm/1.73 sq m, and propranolol, 0.75 mg/kg, were administered orally to 23 children with short stature and 10 children suffering from various disorders. Glucose and insulin tolerance tests and arginine infusions were also utilized in some of these subjects to determine growth hormone (GH) response. Seventeen subjects with short stature had a GH peak greater than 5 ng/ml to the combined levodopa-propranolol provocative test (DPPT). The mean GH peak concentration obtained in this group was 19.6 ± 1.8 (SEM) ng/ml, and in 94.1% of these children the peak was obtained at either 30, 60, or 90 minutes following the administration of the two drugs. Six subjects with short stature who failed to respond to the DPPT had abnormal responses to at least two other stimulatory tests and were classified as GH-deficient. Two subjects among the ten suffering from various disorders failed to respond to the DPPT. The first was a case of chromophobe adenoma of the pituitary gland with primary amenorrhea and luteinizing hormone deficiency, and the second a case of Hand-Schüller-Christian disease. The DPPT appears to be a reliable, safe, and easy-to-perform test to determine GH reserve.

Pituitary volume in children with growth hormone deficiency, idiopathic short stature and controls

2016 ◽  
Vol 29 (10) ◽  
Author(s):  
Marion Kessler ◽  
Michael Tenner ◽  
Michael Frey ◽  
Richard Noto
Keyword(s):  
Growth Hormone ◽  
Magnetic Resonance ◽  
Growth Hormone Deficiency ◽  
Short Stature ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Magnetic Resonance Images ◽  
Idiopathic Short Stature ◽  
Hormone Deficiency ◽  
Significant Difference

AbstractBackground:The objective of the study was to describe the pituitary volume (PV) in pediatric patients with isolated growth hormone deficiency (IGHD), idiopathic short stature (ISS) and normal controls.Methods:Sixty-nine patients (57 male, 12 female), with a mean age of 11.9 (±2.0), were determined to have IGHD. ISS was identified in 29 patients (20 male, 9 female), with a mean age of 12.7 (±3.7). Sixty-six controls (28 female, 38 male), mean age 9.8 (±4.7) were also included. Three-dimensional (3D) magnetic resonance images with contrast were obtained to accurately measure PV.Results:There was a significant difference in the mean PV among the three groups. The IGHD patients had a mean PV 230.8 (±89.6), for ISS patients it was 286.8 (±108.2) and for controls it was 343.7 (±145.9) (p<0.001). There was a normal increase in PV with age in the ISS patients and controls, but a minimal increase in the IGHD patients.Conclusions:Those patients with isolated GHD have the greatest reduction in PV compared to controls and the patients with ISS fall in between. We speculate that a possible cause for the slowed growth in some ISS patients might be related to diminished chronic secretion of growth hormone over time, albeit having adequate pituitary reserves to respond acutely to GH stimulation. Thus, what was called neurosecretory GHD in the past, might, in some patients, be relative pituitary hypoplasia and resultant diminished growth hormone secretion. Thus, PV determinations by magnetic resonance imaging (MRI) could assist in the diagnostic evaluation of the slowly growing child.

Test of growth hormone secretion in adults: poor reproducibility of the insulin tolerance test

1995 ◽  
Vol 133 (3) ◽  
pp. 305-312 ◽  
Author(s):  
Hans C Hoeck ◽  
Peter Vestergaard ◽  
Poul E Jakobsen ◽  
Peter Laurberg
Keyword(s):  
Growth Hormone ◽  
Gh Deficiency ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Repeated Testing ◽  
Provocative Test ◽  
Insulin Tolerance ◽  
Gh Deficiency In Adults

Hoeck HC, Vestergaard P, Jakobsen PE, Laurberg P, Test of growth hormone secretion in adults: poor reproducibility of the insulin tolerance test. Eur J Endocrinol 1995;133:305–12. ISSN 0804–4643 The insulin tolerance test (ITT) is regarded as the most reliable provocative test in the diagnosis of growth hormone (GH) deficiency in adults. In the present study the test was evaluated by investigating the range of GH responses in normal adult males and females and the intra-individual reproducibility of the test. Sixteen healthy non-obese adults, eight males (median age 31.5 years) and eight females (median age 31.8 years) were tested twice with the ITT, with a minimum of 72 h between each test. The females were tested between day 3 and day 10 of their menstrual cycles. Adequate hypoglycemia was achieved in all cases with a median nadir blood glucose of 1.3 mmol/l (range 0.8–2.0). Growth hormone in serum was measured by immunoradiometric assay and low values were confirmed by a different assay. Median peak GH concentration responses to the ITT were: in males 27.9 μg/l, range 5.0–71.1 (test 1) and 30.5 μg/l, range 7.9–69.5 (test 2); and in females 9.0 μg/l, range 4.1–17.9 (test 1) and 8.4 μg/l, range 0.09–42.4 (test 2). The rise in GH concentration during the ITT was higher in males than in females. In the males, all stimulated GH values were ≥5.0 μg/l. In the females, four out of 16 tests gave values below 5.0 μg/l and in one test the GH value was around the detection limit of the assays. There was poor reproducibility during repeated testing, with no correlation between the results of the two tests. The results did not correlate to the magnitude of the hypoglycemia. The results of this study illustrate the complexity of the regulation of GH secretion and indicate that the ITT is less useful for diagnosing GH deficiency in adults than previously anticipated. The diagnosis of GH deficiency in adults and especially in adult females should not be based on the results of a single ITT alone. Hans C Hoeck, Department of Endocrinology, Aalborg Regional Hospital, Reberbansgade, DK-9000 Aalborg, Denmark

EFFECT OF ANDROGEN ON GROWTH HORMONE SECRETION AND GROWTH IN BOYS WITH SHORT STATURE

1979 ◽  
Vol 91 (2) ◽  
pp. 201-212 ◽  
Author(s):  
Luis G. Martin ◽  
Milton S. Grossman ◽  
Thomas B. Connor ◽  
Lynn L. Levitsky ◽  
John W. Clark ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Short Stature ◽  
Sexual Maturation ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Growth Potential ◽  
Hormone Deficiency ◽  
Arginine Infusion ◽  
Young Males ◽  
Before And After

ABSTRACT The response of plasma growth hormone (GH) to insulin-induced hypoglycaemia (IIH) and arginine infusion (AI) was studied in 22 young males (ages 8 to 17 years) with short stature and absent or delayed sexual maturation, before and after androgen administration. During initial evaluation, 5 patients had blunted GH response to IIH, 12 responded subnormally to AI and 4 failed to respond normally to either stimulus. These same studies were repeated in each patient following androgen administration. The source of androgen was as follows: a) 5 days of testosterone propionate (25 mg intramuscularly daily) in 20 patients. b) Methyltestosterone, 10 mg t. i. d. orally for four days in the other 2 subjects. In almost every case, androgen administration resulted in raising the levels of fasting GH and enhancement of the GH responses to IIH and AI was observed. Patients manifesting subnormal GH responses to these stimuli before androgen consistently demonstrated a normal response when challenged with identical stimuli during androgen administration. Growth velocities during the year following these studies were significantly increased in most instances and the growth spurts correlated well with the progression of sexual maturation. Sustained improvement in the GH responses to IIH and AI were uniformly observed in 3 patients when repetitive studies were performed 8 to 12 months later during spontaneous advancing sexual development. The results indicate that brief androgen administration can be helpful in delineating the cause of growth retardation in boys with short stature and delayed sexual maturation, particularly when the diagnosis of isolated growth hormone deficiency is suspected. They also offer prognostic value in determining growth potential in this same group of young males.

Growth hormone therapy for the growth-hormone deficient child

2011 ◽  
pp. 1073-1083
Author(s):  
Jan M. Wit ◽  
Wilma Oostdijk
Keyword(s):  
Growth Hormone ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Present Situation ◽  
Hormone Treatment ◽  
Hormone Deficiency ◽  
Evidence Based ◽  
Test Parameters ◽  
Wide Range ◽  
Deficient Child

In the five decades in which growth hormone has been prescribed for children with growth hormone deficiency (GHD) there has been definite progress, but on the other hand there is still insufficient evidence to answer many basic questions. From an evidence-based perspective the present situation with respect to growth hormone treatment for GHD is therefore far from optimal. First, the diagnosis GHD cannot be defined precisely, because there is a wide range of growth hormone secretion in normally growing individuals, which overlaps with the range observed in children clinically suspected of GHD. Furthermore, all test parameters available have serious drawbacks (1). Therefore, the term GHD stands for a heterogeneous group of congenital or acquired deficiencies (or apparent deficiency). Most patients have an idiopathic isolated GHD, but particularly in that subgroup retesting at the end of growth often shows a normal stimulated growth hormone peak. Of the acquired (organic) GHD, malignancies are the most frequent aetiology, but the incidence of traumatic brain injury may be underestimated.

scholarly journals Clinical Evaluation of Growth Hormone Secretion in Cattle Using Insulin Tolerance Test

2003 ◽  
Vol 65 (7) ◽  
pp. 809-812
Author(s):  
Masafumi OGURO ◽  
Hirotaka ISHIKAWA ◽  
Hiromichi OHTSUKA ◽  
Fumio HOSHI ◽  
Seiichi KAWAMURA
Keyword(s):  
Growth Hormone ◽  
Clinical Evaluation ◽  
Hormone Secretion ◽  
Growth Hormone Secretion ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Insulin Tolerance
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