INTERMITTENT TREATMENT WITH HUMAN GROWTH HORMONE (GH) IN ISOLATED GH DEFICIENCY AND IN MULTIPLE PITUITARY HORMONE DEFICIENCIES

The results of intermittent GH treatment of 3-7 1/2 years duration in seven patients with isolated GH deficiency (IGHD) and five patients with multiple pituitary hormone deficiencies (MPHD) are presented. This therapeutic schedule was found to be comparably effective to those using a continuous-administration schedule. In contradistinction to the findings obtained with the latter, there was no progressive decline in growth velocity. The patients with IGHD were found to respond better than the patients with MPHD both in the first course as well as in consequent courses. In the intervals between courses, the growth velocity was less than in the pretreatment period in both groups. It is concluded that optimal results can be obtained by instituting an initial course of continuous treatment of 1 year's duration for the IGHD patients and of 2 years' duration for the MPHD patients, followed by an intermittent therapeutic schedule. This regime not only leads to the same growth achievement obtained with long-term continuous administration of GH but allows conservation of supplies of this very scarce hormone.     

MULTIPLE PITUITARY HORMONE DEFICIENCIES IN EIGHT SIBLINGS OF ONE JEWISH MOROCCAN FAMILY

Abstract. In a Jewish Moroccan inbred family, 8 of 12 siblings were found to have multiple deficiencies of pituitary hormones, including GH, TSH and gonadotrophins. The parents showed no deficiency and are in good health, as are the other 4 siblings. The investigations carried out indicate that in this family the etiology is hereditary in nature, probably being autosomal recessive, with the defect located in the pituitary gland.     

INSULIN-LIKE GROWTH FACTOR I (IGF-I) IN HEALTHY CHILDREN, ADOLESCENTS AND ADULTS AS DETERMINED BY A RADIOIMMUNOASSAY SPECIFIC FOR THE SYNTHETIC 53–70 PEPTIDE REGION

A radioimmunoassay (RIA) specific for the synthetic 53-70 peptide region of human insulin-like growth factor I (IGF-I) was used to determine IGF-I in the serum of 191 healthy newborns, children and adolescents and in 26 adults. The results compare favourably with reported values obtained using RIA systems for the native IGF-I molecule. Intra- and inter-assay CV were 3.3 and 7.2% respectively. In childhood, mean +/- SD IGF-I levels rise from 6.0 +/- 3.5 nmol/l in newborns to 16.5 +/- 4.0 nmol/l at 8-11 years in both sexes. At the onset of puberty, IGF-I levels in females (24.9 +/- 6.6 nmol/l) are significantly (P greater than 0.005) higher than in males (17.2 +/- 4.2 nmol/l). With further pubertal development IGF-I levels continue to rise, reaching peak values at pubertal stage P4 (40.6 +/- 4.5 nmol/l in males, 42.8 +/- 5.1 nmol/l in females) and decline thereafter to lower values during adulthood: 16.5 +/- 5.8 nmol/l (males) and 24.2 +/- 7.0 nmol/l (females) (P greater than 0.001). In pubertal males, IGF-I correlates significantly with height (r = 0.66, P less than 0.001), bone age (r = 0.69, P less than 0.001) and growth velocity (r = 0.64, P = 0.025) as well as with testosterone levels (r = 0.69, P less than 0.001). In pubertal females a significant correlation is found between IGF-I and height (r = 0.55, P less than 0.020). The ready availability of a simple, precise and reproducible IGF-I RIA, should contribute much to evaluating the importance of IGF-I measurements in normal growth and in the diagnosis and therapy of various growth disorders.     

THE EFFECT OF METHANDROSTENOLONE ON PITUITARY GROWTH HORMONE SECRETION IN PREPUBERTAL CHILDREN

The effect of methandrostenolone on plasma growth hormone levels was studied in twenty-two apparently healthy prepubertal children (nineteen males and three females) with idiopathic growth retardation, following insulin hypoglycaemia (eight children) or arginine infusion (fourteen children). The tests were performed before and after 5 days or 34 months of peroral administration of methandrostenolone (0.1 54.33 or 0.03-0.05 mg/kg/day, respectively).     

Eustachian tube function during pregnancy

The upper respiratory mucosa has been reported to react to sex hormones in both physiological and pathological conditions. The present study was specifically aimed to determine the influence of high levels of oestrogen on Eustachian tube function. Fifty-three healthy, pregnant women were prospectively evaluated for Eustachian tube function during pregnancy. Eustachian tube function was found to be highly variable in different women, and in the same woman at different stages of pregnancy. We did not find a specific trend in Eustachian tube function with increasing oestrogen levels as encountered during pregnancy.     

The Pattern of Growth in Children with Constitutional Tall Stature from Birth to Age 9 Years

A study was made of the longitudinal growth pattern of 29 girls and 36 boys with constitutional tall stature (CTS) from birth to age 9 years. In these children, all of whom had a normal birth length, there was very rapid growth during the first 4 years of life, following which growth velocity dropped to normal and remained parallel to the 50th percentile. In the 49 subjects for whom actual final height was also obtained there was a very good agreement between this and the final height as predicted by Tanner's method from the height at ages 4 and 8 years. Significant differences were found between the mean maternal, paternal and mid-parental height and the tall stature of their offspring, but there was a very good correlation between the individual patients final height and their parental heights. The findings of this study stress the importance of periodical measurements of length and height in all children during the first few years of life so as to have appropriate data on which to base future considerations of possible therapy.