Hypopituitarism: A Study of Growth Hormone and Other Endocrine Functions

Article1 June 1966Hypopituitarism: A Study of Growth Hormone and Other Endocrine FunctionsMITCHELL T. RABKIN, M.D., ANDREW G. FRANTZ, M.D.MITCHELL T. RABKIN, M.D.Search for more papers by this author, ANDREW G. FRANTZ, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-64-6-1197 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo make the diagnosis of pituitary insufficiency a variety of approaches may be required. Among the simplest are those that evaluate physiological functions of the target organs. For example, the occurrence of regular menstrual cycles implies integrity of gonadotropin secretion. When physiological function is less easily assessed clinically, estimation of the hormonal output of the target gland is often used as an index of pituitary adequacy. Ideally, however, direct quantitation of the pituitary hormones themselves is preferable. The only pituitary hormones commonly measured directly are the gonadotropins, but the bioassay generally used is imprecise and does not always reliably distinguish...References1. YALOWBERSON RSSA: Immunoassay of endogenous plasma insulin in man. J. Clin. Invest. 39: 1157, 1960. CrossrefMedlineGoogle Scholar2. GLICKROTHYALOWBERSON SMJRSSA: Immunoassay of human growth hormone in plasma. Nature (London) 199: 784, 1963. CrossrefMedlineGoogle Scholar3. HUNTERGREENWOOD WMFC: A radioimmunoelectrophoretic assay for human growth hormone. Biochem. J. 91: 43, 1964. CrossrefMedlineGoogle Scholar4. GLICKROTHYALOWBERSON SMJRSSA: The regulation of growth hormone secretion. Recent Progr. Hormone Res. 21: 241, 1965. MedlineGoogle Scholar5. DAUGHADAYPARKER WHML: Human pituitary growth hormone. Ann. Rev. Med. 16: 47, 1965. CrossrefMedlineGoogle Scholar6. YALOWGLICKROTHBERSON RSSMJSA: Radioimmunoassay of human plasma ACTH. J. Clin. Endocr. 24: 1219, 1964. CrossrefGoogle Scholar7. ODELLWILBERPAUL WDJFWE: Radioimmunoassay of thyrotropin in human serum. J. Clin. Endocr. 25: 1179, 1965. CrossrefMedlineGoogle Scholar8. UTIGER RD: Radioimmunoassay of human plasma thyrotropin. J. Clin. Invest. 44: 1277, 1965. CrossrefMedlineGoogle Scholar9. FRANTZRABKIN AGMT: Human growth hormone: clinical measurement, response to hypoglycemia and suppression by corticosteroids. New Eng. J. Med. 271: 1375, 1964. CrossrefMedlineGoogle Scholar10. HOFFMAN WS: Rapid photoelectric method for determination of glucose in blood and urine. J. Biol. Chem. 120: 51, 1937. CrossrefGoogle Scholar11. ALBERT A: Human urinary gonadotropin. Recent Progr. Hormone Res. 12: 227, 1956. MedlineGoogle Scholar12. BRADBURYBROWNBROWN JTESWE: Adsorption of urinary gonadotrophins on kaolin. Proc. Soc. Exp. Biol. Med. 71: 228, 1949. CrossrefMedlineGoogle Scholar13. KLIMANBRIEFER BC: Gas-liquid chromatography of carbon-14 and tritium labeled steroids. Program of the forty-sixth meeting of the Endocrine Society, San Francisco, California, June 18-20, 1964. Abstract No. 61. Google Scholar14. TAUNTONMCDANIELPITTMAN ODHGJA: Standardization of TSH testing. J. Clin. Endocr. 25: 266, 1965. CrossrefMedlineGoogle Scholar15. LIDDLERICHARDPETERSON GWJERE: An improved method for assaying the steroidogenic potency of ACTH. Endocrinology 57: 594, 1955. CrossrefMedlineGoogle Scholar16. LIDDLEESTEPKENDALLWILLIAMSTOWNES GWHLJWWCAW: Clinical application of a new test of pituitary reserve. J. Clin. Endocr. 19: 875, 1959. CrossrefMedlineGoogle Scholar17. FRANTZRABKIN AGMT: Effects of estrogen and sex difference on secretion of human growth hormone. J. Clin. Endocr. 25: 1470, 1965. CrossrefMedlineGoogle Scholar18. ROTHGLICKYALOWBERSON JSMRSSA: Hypoglycemia: a potent stimulus to secretion of growth hormone. Science 140: 987, 1963. CrossrefMedlineGoogle Scholar19. BRASELWRIGHTWILKINSBLIZZARD JAJCLRM: An evaluation of seventy-five patients with hypopituitarism beginning in childhood. Amer. J. Med. 38: 484, 1965. CrossrefMedlineGoogle Scholar20. DAUGHADAYPARKER WHML: Sulfation factor measurement as an aid in the recognition of pituitary dwarfism. J. Clin. Endocr. 23: 638, 1963. CrossrefGoogle Scholar21. NADLERNEUMANNGERSHBERG HLLLH: Hypoglycemia, growth retardation, and probable isolated growth hormone deficiency in a 1-year-old child. J. Pediat. 63: 977, 1963. CrossrefMedlineGoogle Scholar22. WILBERODELL JFWD: Hypoglycemia and dwarfism associated with the isolated deficiency of growth hormone. Metabolism 14: 590, 1965. CrossrefMedlineGoogle Scholar23. PETERSGERMANMANWELT JPWJEBLG: Functions of gonads, thyroid and adrenals in hypopituitarism. Metabolism 3: 118, 1954. MedlineGoogle Scholar24. HÖKFELTLUFT BR: The effect of suprasellar tumours on the regulation of adrenocortical function. Acta Endocr. (Kobenhavn) 32: 177, 1959. MedlineGoogle Scholar25. KAPLAN NM: Assessment of pituitary ACTH secretory capacity with Metopirone: 1. Interpretation. J. Clin. Endocr. 23: 945, 1963. CrossrefMedlineGoogle Scholar26. KRIEGERKOLODNYKRIEGER DTHHP: Methopyrapone tests in hypothalamic-pituitary disease. J. Clin. Endocr. 24: 1169, 1964. CrossrefGoogle Scholar27. GOLDKENTFORSHAM EMJRPH: Clinical use of a new diagnostic agent, methopyrapone (SU-4885), in pituitary and adrenocortical disorders. Ann. Intern. Med. 54: 175, 1961. LinkGoogle Scholar28. SOLEMBRINCK-JOHNSEN JHT: Indirect estimation of pituitary corticotropin reserve in man by use of an adrenocortical 11 β-hydroxylase inhibitor (SU-4885 Ciba). Acta Med. Scand. 170: 89, 1961. CrossrefGoogle Scholar29. KAPLAN NM: Assessment of pituitary ACTH secretory capacity with Metopirone: II. Comparison with other tests. J. Clin. Endocr. 23: 953, 1963. CrossrefGoogle Scholar30. OPPENHEIMERFISHERJAILER JHLVJW: Disturbance of the pituitary-adrenal interrelationship in diseases of the central nervous system. J. Clin. Endocr. 21: 1023, 1961. CrossrefGoogle Scholar31. BRINCK-JOHNSENSOLEMBRINCK-JOHNSENINGVALDSEN TJHKP: The 17-hydroxycorticosteroid response to corticotropin, metopiron and bacterial pyrogen. Acta Med. Scand. 173: 129, 1963. CrossrefMedlineGoogle Scholar32. JENKINSELKINGTON JSSG: Metyrapone and pyrogen in the assessment of pituitary-adrenal function after removal of pituitary adenoma. Lancet 2: 991, 1964. CrossrefMedlineGoogle Scholar33. AARSKOGBLIZZARDMIGEON DRMCJ: Response to methopyrapone (Su-4885) and pyrogen test in idiopathic hypopituitary dwarfism. J. Clin. Endocr. 25: 439, 1965. CrossrefGoogle Scholar34. RUSSFIELD AB: Histology of the human hypophysis in thyroid disease—hypothyroidism, hyperthyroidism, and cancer. J. Clin. Endocr. 15: 1393, 1955. CrossrefGoogle Scholar35. VAN WYKGRUMBACH JJMM: Syndrome of precocious menstruation and galactorrhea in juvenile hypothyroidism: an example of hormonal overlap in pituitary feedback. J. Pediat. 57: 416, 1960. CrossrefGoogle Scholar36. FURTH J: Experimental pituitary tumors. Recent Progr. Hormone Res. 11: 221, 1955. Google Scholar37. MELNYKGREER CSMA: Functional pituitary tumor in an adult possibly secondary to long-standing myxedema. J. Clin. Endocr. 25: 761, 1965. CrossrefGoogle Scholar38. GANONGHUME WFDH: The effect of graded hypophysectomy on thyroid, gonadal, and adrenocortical function in the dog. Endocrinology 59: 293, 1956. CrossrefMedlineGoogle Scholar39. SMITH PE: The secretory capacity of the anterior hypophysis as evidenced by the effect of partial hypophysectomies in rats. Anat. Rec. 52: 191, 1932. CrossrefGoogle Scholar40. VAN BURENBERGENSTAL JMDM: An evaluation of graded hypophysectomy in man. A quantitative functional and anatomical study. Cancer 13: 155, 1960. CrossrefMedlineGoogle Scholar41. STEINBERGSHECHTERSEGAL AFRHI: True pituitary Addison's disease—a pituitary unitropic deficiency. J. Clin. Endocr. 14: 1519, 1954. CrossrefGoogle Scholar42. KLOTZROBELTUTIN HPPM: Trois cas de maladie d'Addison d'origine hypophysaire avec pigmentation cutanée. Ann. Endocr. (Paris) 19: 1031, 1958. Google Scholar43. CLEVELANDGREENMIGEON WWOCCJ: A case of proved adrenocorticotropin deficiency. J. Pediat. 57: 376, 1960. CrossrefMedlineGoogle Scholar44. ODELLGREENWILLIAMS WDGMRH: Hypoadrenotropism: the isolated deficiency of adrenotropic hormone. J. Clin. Endocr. 20: 1017, 1960. CrossrefGoogle Scholar45. PERKOFFEIK-NESCARNESTYLER GTKWHFH: Selective hypopituitarism with deficiency of anterior pituitary basophils: a case report. Ibid., p. 1269. Google Scholar46. AVIOLIEARLEYKASHIMA LVLEHK: Chronic and sustained hypernatremia, absence of thirst, diabetes insipidus, and adrenocorticotrophin insufficiency resulting from widespread destruction of the hypothalamus. Ann. Intern. Med. 56: 131, 1962. LinkGoogle Scholar47. ARKYFREINKEL RAN: The response of plasma human growth hormone to insulin and ethanol-induced hypoglycemia in two patients with "isolated adrenocorticotropic defect." Metabolism 13: 547, 1964. CrossrefMedlineGoogle Scholar48. LOHRENZFERNANDEZDOE FNRRP: Isolated thyrotropin deficiency. Review and report of three cases. Ann. Intern. Med. 60: 990, 1964. LinkGoogle Scholar49. KAPLANSHEDIAC NMC: The recognition of isolated thyrotropin (TSH) deficiency. Program of the forty-seventh meeting of the Endocrine Society, New York City, June 17-19, 1965. Abstract No. 155. Google Scholar50. HELLERNELSON CGWO: Classification of male hypogonadism and a discussion of the pathologic physiology, diagnosis and treatment. J. Clin. Endocr. 8: 345, 1948. CrossrefGoogle Scholar51. KALLMANSCHOENFELDBARRERA FJWASE: The genetic aspects of primary eunuchoidism. Amer. J. Ment. Defic. 48: 203, 1944. Google Scholar52. NOWAKOWSKILENZ HW: Genetic aspects in male hypogonadism. Recent Progr. Hormone Res. 17: 53, 1961. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston, MassachusettsFrom the Departments of Medicine, The Massachusetts General Hospital, and Harvard Medical School, Boston, Mass.This study was supported in part by grants AM-4080, AM-4501, and AM-5205, U. S. Public Health Service, Washington, D. C.Requests for reprints should be addressed to Mitchell T. Rabkin, M.D., The Massachusetts General Hospital, Boston, Mass. 02114. 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