Abstract
In 47 children with disturbances in growth and/or puberty a test was performed with simultanous injection of insulin (0.1 U/kg), TRH (3-5 μg/kg) and LHRH (100 μg). The mean bone age retardation was 39 months and the mean standard deviation score - 2.8 SD. In 11 children a Growth Hormone deficiency (GHD) was demonstrated: GH peak value 3.34 mU/1 and Somatomedin 0.63 U/ml (mean) - 5 of these were patients with intracranial tumours. The other 36 children had GH peak value 20.44 mU/1 and Somatomedin 1.27 U/ml (mean). ACTH response was subnormal in 15/32. In these 15 patients 13 had GHD or subnormal GH response. In the 15 children in the highest age group (girls > 12 years, boys > 14 years) a normal response to LHRH was found, regardless of pubertal development or coexisting GHD. In the 24 children in the youngest age group was found a definite abnormal response in 4, two of which had GHD. TSH response was low in 6/45, three of which were hypothyroid and had GHD. Defect of 3 pituitary axes were found in 5 patients, 3 of these had intraoranial tumour. In conclusion: The combined test of pituitary function seems to be of limited value. The essential information is acquired by the hypoglycemia to establish GHD and ACTH deficiency (these 2 are often coexisting). Stimulation with LHRH is valuable in older children without signs of puberty and may be of prognostic value in young prepubertal children with GHD. Stimulation with TRH does not give any supplemental information.
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Petersen, K., Jacobsen, B., Kastrup, K. et al. Evaluation of the combined test of hypothalamio-pituitary function. Pediatr Res 15, 90 (1981). https://doi.org/10.1203/00006450-198101000-00116
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DOI: https://doi.org/10.1203/00006450-198101000-00116