Abstract
One hundred forty nine children and adolescents with growth hormone (hGH) deficiency were reviewed retrospectively in relation to plasma basal and TRH stimulated prolactin (Prl) levels before and during long-term hGH therapy. The following groups were distinguished: Gr. I - IGHD (n=62, 41M, 21F); Gr. II - MPHD (n=62, 44M, 18F); Gr. III - Intra- or suprasellar tumors (n=25, 17M, 8F). High basal Prl (> 20 ng/dl) were found in 6 IGHD patients (9.7%). During hGH therapy Prl normalized in all six. Nineteen (30.7%) MPHD patients had high basal Prl. Following L-T4 therapy Prl normalized in 14 of them. All MPHD patients with high basal Prl had higher than normal TSH response to TRH. High basal Prl levels were unrelated to stress and E2 therapy. It is assumed that in some hypopituitary patients hGH deficiency is due to hypoactivity of the catccholaminergic tone leading to GH-RH deficiency and high Prl levels. This is reversed by hGH therapy. A low response of Prl was found in 10 IGHD and 10 (16.1%) MPHD patients. A pituitary lesion was proven in these patients by a low response of GH to GH-RH and TSH to TRH. It thus seems that some IGHD patients are actually MPHD being deficient in both hGH and Prl. In the tumor patients, 2 had high Prl preoperatively. Post-op 5 had a low Prl response to TRH indicating complete hypophysectomy and 6 develope high Prl levels indicating hypothalamic or stalk injury. It is concluded that dynamics of hPrl secretion should be investigated in all hypopituitary patients, including IGHD.
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Witz, L., Silbergeld, A. & Laron, Z. 76 PROLACTIN SECRETION IN 149 hGH DEFICIENT CHILDREN. Pediatr Res 24, 529 (1988). https://doi.org/10.1203/00006450-198810000-00097
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DOI: https://doi.org/10.1203/00006450-198810000-00097