Abstract
The GHRF test is thought to be able to differentiate pitutary from hypothalamic defects in GH-deficient patients. Our purpose was to verify if the information obtained via GHRF test was in agreement with that of by the TRH and LHRH tests performed in pituitary subjects followed from 2 to 12 yrs. Subjects: 36 pituitary patients subdivided into 3 groups: I) 11 with normal puberty; II) 9 with pharmacologically induced puberty; III) 16 prepubertal with bone age < 12 yrs. GRF test (3 ug/Kg iv): a peak>4 ng/ml was present in 10 subjects in group I (91% hypothalamic defect), 3 in group II (33% hypothalamic), 9 in group III {56% hypothalamic). TRH test (100 ug iv): group I normal response, no subject needed replacement therapy; group II only one with a normal hypothalamo-pituitary-thyroidal axis, and 8 with hypothyroidism and a delayed and prolonged TSH response (hypothalamic deficiency 100%); group III: 4 with hypothyroidism ( 100% hypothalamic). LHRH test (50 ug iv): LH and FSH were significantly different in the 3 groups only after the start of puberty or when bone age was > 12 yrs. Conclusions: a) almost all patients with isolated GH deficit seem to be hypothalamic, b) patients with hypothyroidism all seem to be hypothalanic considering TSH response; GHRF test results are however concordant only in 50% of cases, c) the LHRH test is unable to detect hypogonadism in prepubertal pituitary patients and the level of the defect in hypogonadic subjects.
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Pirazzoli, P., Mandini, M., Balestrazzi, A. et al. DISCORDANCES IN RELEASING TESTS IN DETECTING THE SITE OF THE DEFICIENCY IN PITUITARY PATIENTS. Pediatr Res 20, 1189 (1986). https://doi.org/10.1203/00006450-198611000-00095
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DOI: https://doi.org/10.1203/00006450-198611000-00095