Ketotic Hypoglycemia and Hypopituitarism

A 5-year-old girl had hypoglycemia and was of short stature. Studies of pituitary function demonstrated combined growth hormone and adrenocorticotropic hormone (ACTH) deficiency. She was shown to have ketotic hypoglycemia. In contrast to patients previously reported with hypopituitarism and ketotic hypoglycemia, she had no deficiency of gluconeogenic substrate. Serum levels of alanine and other gluconeogenic amino acids were normal during fasting and hypoglycemia. These studies suggest that inadequate gluconeogenic precursors are not the cause of her ketotic hypoglycemia. Ketotic hypoglycemia in association with hypopituitarism may be secondary to multiple biochemical defects.

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Ghrelin and growth hormone serum levels during the clonidine test in children with short stature and variable growth hormone status

HORMONES ◽

10.14310/horm.2002.1291 ◽

2011 ◽

Vol 10 (1) ◽

pp. 39-45 ◽

Cited By ~ 2

Author(s):

Charilaos Stylianou ◽

Assimina Galli-Tsinopoulou ◽

Maria Grammatikopoulou ◽

George Koliakos ◽

George Varlamis

Keyword(s):

Growth Hormone ◽

Short Stature ◽

Serum Levels ◽

Hormone Status

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Tumor Tissue Identification in the Pseudocapsule of Pituitary Adenoma: Should the Pseudocapsule be Removed for Total Resection of Pituitary Adenoma?

Operative Neurosurgery ◽

10.1227/01.neu.0000330406.73157.49 ◽

2009 ◽

Vol 64 (suppl_1) ◽

pp. ONS62-ONS70 ◽

Cited By ~ 9

Author(s):

Eun Jig Lee ◽

Jung Yong Ahn ◽

Taewoong Noh ◽

Se Hun Kim ◽

Tai Seung Kim ◽

...

Keyword(s):

Growth Hormone ◽

Pituitary Adenoma ◽

Recurrence Rate ◽

Adrenocorticotropic Hormone ◽

Tumor Tissue ◽

Remission Rate ◽

Pituitary Function ◽

Subtotal Resection ◽

Total Resection ◽

Resection Group

Abstract Objective: The microsurgical pseudocapsule can be found in the transition zone between an adenoma and the surrounding normal pituitary tissue. We investigated the precise histology of the pseudocapsule. Furthermore, we evaluated the remission rate, the changes in pituitary function, and the recurrence rate after intensive resection of the pseudocapsule. Methods: In 616 patients with pituitary adenomas (Hardy Types I–III) over a period of 14 years, we introduced intensive resection of the microsurgical pseudocapsule to achieve complete tumor removal. A combined pituitary function test and radiological study were performed on the patients before surgery, 1 year after surgery, and at subsequent 1.5-year intervals 2 to 13 years postoperatively. Results: Microsurgical pseudocapsules were identified in 343 (55.7%) of 616 patients, and the distinct microsurgical pseudocapsules were observed in 180 (52.5%) of these patients. In the remaining 163 patients, the microsurgical pseudocapsules were incompletely developed. Tumor cluster infiltration was present in the pseudocapsule in 71 (43.6%) of these patients. Aggressive resection of the microsurgical pseudocapsule was more often required in larger tumors than in smaller ones. The presence of a pseudocapsule was slightly more frequent in prolactin-secreting tumors (70.9%) than in growth hormone-secreting (55.0%) and adrenocorticotropic hormone-secreting (40.0%) tumors. In the 243 patients of the total resection group who underwent combined pituitary function tests more than 2 times after surgery, the surgical remission rate was 99.1 % in clinically nonfunctional tumors, 88% in growth hormone-secreting, 70.6% in prolactin-secreting, and 100% in adrenocorticotropic hormone-secreting tumors. The surgical remission rate was 86.2% in the presence of a pseudocapsule and 94.3% in the absence of a pseudocapsule. Preoperative hypopituitarism improved in 140 patients (57.6%), persisted in 47 patients (19.3%), and was aggravated in 33 patients (13.6%). There was no statistical difference in improvement or deterioration of pituitary function according to the existence or absence of the pseudocapsule. The tumor recurrence rate was 0.8% in the total resection group and was 42.1 % in the subtotal resection group. Conclusion: We have shown that tumor tissue is frequently present within the pseudocapsule, suggesting that any tumor remnant in the pseudocapsule could be a source of recurrence and an obstacle to achieving complete remission. These results indicate that intensive resection of the pseudocapsule could result in a higher remission rate without deteriorating pituitary function.

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Association between lipid profile and other biochemical parameters with growth hormone in children and adolescents with short stature

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11i3.2642 ◽

2020 ◽

Vol 11 (3) ◽

pp. 4295-4302

Author(s):

Saja S. Falih ◽

Falah S. Al-Fartusie ◽

Noor T. Tahir

Keyword(s):

Growth Hormone ◽

Lipid Profile ◽

Children And Adolescents ◽

Short Stature ◽

Serum Levels ◽

General Term ◽

Hormone Deficiency ◽

Early Age ◽

Kidney Functions ◽

Age Range

Short stature is a general term that usually accompanies a lack of growth hormone among people, and is more common among children. In this study, some kidney functions and lipid profile tests were evaluated in children and adolescents with short stature to find any relationship between the disturbance in these parameters and the etiology of short stature. A total of 60 short stature patients with a growth hormone deficiency, age range between 4-18 years, along with 60 age-matched healthy volunteers, were included in this study. Serum levels of GH, IGF-1, urea, and creatinine, as well as lipid profile, were determined, and then statistical analysis was performed on the collected data. The obtained results indicated a significant decrease in serum levels of GH and IGF-1 (p <0.01) in patients compared to control values. The results also indicated a substantial increase in serum levels of triglycerides and VLDL, mainly seen in children, and reported non-significant differences in HDL, LDL, and urea levels for GHD patients compared to control values. Additionally, the results showed a significant increase in the creatinine level of adolescent patients only. This study concluded that there is a clear relationship between disturbances in creatinine levels and the promotion of GHD in short stature patients. Current work has demonstrated that anomalies in the lipid profile, especially triglycerides and VLDL, are closely related to the causes of short stature. Finally, and most importantly, we can suggest that triglycerides and VLDL may help identify patients at an early age who are at risk of short stature, especially children.

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FREQUENT HYPOGLYCEMIA INDUCED BY GROWTH HORMONE (GH) AND ADRENOCORTICOTROPIC HORMONE (ACTH) DEFICIENCY IN CHRONIC RENAL FAILURE

Nihon Naika Gakkai Zasshi ◽

10.2169/naika.69.460 ◽

1980 ◽

Vol 69 (4) ◽

pp. 460-465 ◽

Cited By ~ 3

Author(s):

Kensuke SUZUKI ◽

Mari HOSHIYAMA ◽

Takeshi MUROHASHI ◽

Okuhiro ARAI

Keyword(s):

Growth Hormone ◽

Renal Failure ◽

Chronic Renal Failure ◽

Adrenocorticotropic Hormone ◽

Acth Deficiency

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Glycine stimulates growth hormone release in man

Acta Endocrinologica ◽

10.1530/acta.0.0930283 ◽

1980 ◽

Vol 93 (3) ◽

pp. 283-286 ◽

Cited By ~ 8

Author(s):

Kikuo Kasai ◽

Hitoshi Suzuki ◽

Tsutomu Nakamura ◽

Hiroaki Shiina ◽

Shin-Ichi Shimoda

Keyword(s):

Growth Hormone ◽

Blood Sugar ◽

Normal Subjects ◽

Serum Levels ◽

Pituitary Function ◽

Before And After ◽

Sugar Levels ◽

Dose Dependent ◽

Serum Gh ◽

Different Doses

Abstract. The influence of glycine, the simplest amino acid, on pituitary function has been investigated in the present study. Different doses (4, 8 or 12 g) of glycine were intravenously infused over 15 or 30 min in normal subjects. Serum levels of GH (growth hormone) and Prl (prolactin) were measured before and after the infusion, and also blood sugar levels were determined. The dose of 4 or 8 g glycine induced a significant increase in serum GH (P < 0.05 or P< 0.001, respectively); however, a more pronounced and significant increase in serum GH levels was observed after infusion at a dose of 12 g glycine (P < 0.001). It was clearly observed that the dose-dependent GH release to intravenous glycine occurred in normal subjects. On the contrary, serum Prl level was not changed significantly, and blood sugar level was transiently, but significantly (P < 0.05), increased after the infusion of 12 g glycine. The present data suggest that glycine might play an important role in the control of hypothalamic-pituitary function.

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