Abstract
Normal or accelerated growth in the absence of growth hormone (GH) occurs in some patients following surgery for craniopharingioma. To elucidate the mechanism of growth, blood levels of prolactin (Pr) insulin (IRI) and somatomedin (Sm) activity were measured in 8 children following removal of the tumor. In all patients GH responses were subnormal following insulin-induced hypoglycemia, arginine and L-dopa. Growth rates were 3.5 to 10.8 cm/year with a mean of 6.1 ± 0.9 (SEM) cm. Serum Pr was normal in 4 patients; in 3, vasopressin antibodies interfered with the assay. Sm activity was low in one patient and normal in 6. In 7 patients with adequate growth mean peak IRI levels were 125.57 ±26.74 (SEM) μU/ml after oral glucose (G); 71.00 ±24.37 (SEM) μU/ml after I-V tolbutamide (T) and 91.83 ± 34.40 (SEM) μU/ml after I-V arginine (A). These values were similar to or higher than mean peak IRI in normal children [ 79.55± 19.73 (SEM) μU/ml after G; 56.22 ± 10.79 (SEM) μU/ml after T and 40.7 ± 7.0 (SEM) μU/ml after A] and in children with idiopathic hypopituitarism [34.00 ± 7.43 (SEM) μU/ml after G and 11.50 ± 1.73 (SEM) μU/ml after T]. One patient with suboptimal growth had normal Sm but low IRI levels (30 μU/ml after G and 25 μU/ml after T).
These data suggest that: a) insulin may be the growth promoting hormone in these patients; b) Sm may not be necessary for postoperative growth and does not appear to be generated by Pr.
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Costin, G., Kogut, M. INSULIN: GROWTH PROMOTING HORMONE IN CRANIOPHARINGIOMA. Pediatr Res 8, 368 (1974). https://doi.org/10.1203/00006450-197404000-00167
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DOI: https://doi.org/10.1203/00006450-197404000-00167