Growth hormone secretion dynamics in a patient with ectopic growth hormone-releasing factor production |
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| Authors: | J L Ch'ng N D Christofides M E Kraenzlin A Keshavarzian J M Burrin I L Woolf H J Hodgson S R Bloom |
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| Affiliation: | 1. Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital London, England;2. Department of Medicine, North Middlesex Hospital, Edmonton, London, England;1. Department of Surgical Oncology, Section of Surgical Endocrinology, University of Texas MD Anderson Cancer Center, Houston, TX;2. Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas MD Anderson Cancer Center, Houston, TX;3. Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX;1. Department of Public Health and Welfare, Finnish Institute for Health and Welfare, P.O.Box 30, 00271 Helsinki, Finland;2. Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland;3. Health Sciences Unit, University of Tampere, 33014 Tampere, Finland;4. Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627 FI-70211 Kuopio, Finland;1. Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands;2. School of Medicine and Pharmacology, The University of Western Australia, Perth, Australia;3. Centre for Kidney Research, Children''s Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia;4. Department of Biostatistics, Erasmus MC, Rotterdam, The Netherlands;5. Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands;6. Leiden University College, The Hague, The Netherlands;1. Department of Information & Communication Systems Engineering, University of the Aegean, Karlovassi, Samos, 83200, Greece;2. Department of Computer Engineering and Informatics, University of Patras, 26500 Patras, Greece;3. Computer Technology Institute & Press “Diophantus”, N. Kazantzaki Str, Patras University Campus, 26504 Patras, Greece;4. Department of Informatics, Aristotle University of Thessaloniki, Greece;1. Dipartimento di Meccanica, Matematica e Management, Politecnico di Bari, Bari, Italy;2. Istituto Nazionale di Fisica Nucleare (INFN) – Sezione di Bari, Bari, Italy;3. Consiglio Nazionale delle Ricerche – Istituto di Fotonica e Nanotecnologie (CNR-IFN), Bari, Italy;4. EnginSoft SpA, Trento, Italy |
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| Abstract: | ![]()
A female patient with acromegaly, hypercalcemia, and Zollinger-Ellison syndrome was found to have a very high plasma concentration (average 2,300 pmol/liter; normal less than 50 pmol/liter) of growth hormone-releasing factor as measured by a radioimmunoassay to human pituitary growth hormone-releasing factor-1-44. The plasma concentration of growth hormone averaged 25 mIU/liter (normal less than 5 mIU/liter) and there was no rise following an intravenous 100 micrograms bolus of human pituitary growth hormone-releasing factor-1-44. Plasma growth hormone and growth hormone-releasing factor levels were unaffected by bromocriptine, insulin-induced hypoglycemia, and sleep. A long-acting somatostatin analogue lowered both the growth hormone-releasing factor and the growth hormone levels. Thyrotropin-releasing hormone stimulation and oral glucose tolerance tests produced significant increases in plasma growth hormone levels whereas the growth hormone-releasing factor level remained unchanged, suggesting that when normal somatotrophs are exposed to maximal growth hormone-releasing factor stimulation, thyrotropin-releasing hormone becomes a secretagogue of growth hormone from the pituitary. It is proposed that in the absence of a radioimmunoassay for growth hormone-releasing factor, a lack of growth hormone response to growth hormone-releasing factor in a patient with acromegaly is compatible with a source of ectopic growth hormone-releasing factor production. |
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