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Prolactin and Somatomedin in Hypopituitary Patients with "Catch-up" Growth Following Operations for Craniopharyngioma

Departments of Pediatrics, University of Pittsburgh School of Medicine, and Indiana University School of Medicine and the Protein and Polypeptide Hormone Laboratory, McGill University Clinic, Royal Victoria Hospital Montreal, Canada

Four patients had insufficiency of hGH, TSH, ACTH, and ADH following surgery for craniopharyngiomas. Despite hypopituitarism, and without hGH therapy, all showed "catch-up" growth during post-operative follow up. Prolactin, determined by RAI was normal in every patient, and therefore cannot be responsible for the increase in post-operative growth rate. Their prolactin values were similar to those of a large series of children with idiopathic hypopituitarism. In determined by bioassay and was normal. An additional patient who showed a normal growth rate (without "catch-up") postoperatively also had normal somatomedin in the absence of growth hormone response to provocative tests. While the mechanism for catch-up growth in the patients remains enigmatic, the possibility cannot be excluded that hyperinsulinism could play a role, inasmuch as these patients are generally obese secondary to voracious appetites.

Supported in part by USPHS-HD-01727-07; RR-84; RR-56 and FR-05507; MRC-MA 4403 and MT-1862; Quebec MRC 710034; the Renziehausen Fund, and the James Whitcomb Riley Memorial Association Project #69-6.

Received May 19, 1972.

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