Abstract
A paradoxical GH response to TRH has been described in constitutional tall stature. Bromocriptine (BR) therapy has consequently been proposed to reduce adult height prediction in tall but otherwise normal children. This study evaluates the GH response (0-180min) to a single dose (0.2mg) of TRH (n=59) in 11 tall children followed prospectively before (A1) and after (A2) 6 months of treatment with BR (5mg/d), while still on therapy, in 9 children of average height (B), 12 with precocious puberty (C), 9 with delayed puberty (D) and 7 with GH deficiency (E). Peaks of GH (> 5ng/ml) were observed in 92.3% of cases from groups A to D, whereas none occurred in group E. They occurred mainly beyond 120 minutes (57.6%) and were of similar magnitude in groups A1, A2 and B., In addition, a bifid secretion pattern occurred in 43.5% of cases. In these patients, the early peak was unrelated to stress (normal prolactin). In conclusion, the mode of GH response as well as GH peak amplitude following TRH remain similar in tall and in average height children who are matched for bone age. In group A2, BR failed to modify the GH secretory pattern following TRH injection. The pattern of GH secretion observed after TRH might be the expression of its normal amplified pulsatile secretion mode during puberty and thus be independent of TRH.
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Theintz, G., Tang, Z., Marti, C. et al. GROWTH HORMONE (GH) RESPONSE TO THYROTROPIN-RELEASING HORMONE (TRH) DURING PUBERTY: A REAPPRAISAL. Pediatr Res 20, 1181 (1986). https://doi.org/10.1203/00006450-198611000-00046
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DOI: https://doi.org/10.1203/00006450-198611000-00046
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