Journal of Clinical Endocrinology & Metabolism, Vol 61, 585-587, Copyright © 1985 by Endocrine Society

ARTICLES

Failure to respond to growth hormone releasing hormone (GHRH) in acromegaly due to a GHRH secreting pancreatic tumor: dynamics of multiple endocrine testing

HM Schulte, G Benker, R Windeck, T Olbricht and D Reinwein

Growth hormone releasing hormone (GHRH) has recently been isolated and sequenced from pancreatic tumors secreting GHRH. Patients with untreated acromegaly due to a pituitary tumor respond to exogenous administration of GHRH with a further rise of their elevated basal growth hormone (GH) levels. For the first time, we report the effects of exogenously administered synthetic GHRH in a patient with acromegaly due to a GHRH secreting pancreatic tumor. The diagnosis was established by high peripheral IR-GHRH levels (1100 pg/ml) and an arterio- venous tumor gradient of IR-GHRH. In this patient GH failed to respond to 1 microgram/kg of exogenous GHRH with the pancreatic tumor in situ; however, further increase of serum GH levels occurred after TRH administration, hypoglycemia and oral glucose administration. After removal of the tumor, serum GH levels decreased and a normal response to GHRH and TRH were demonstrated. The extract of the tumor contained 1.7 micrograms IR-GHRH per g wet tissue. Thus, lack of response to exogenous GHRH in untreated acromegaly may indicate the presence of an ectopic GHRH producing tumor.

This article has been cited by other articles:

				A. Matsuno, H. Katakami, N. Sanno, Y. Ogino, R. Y. Osamura, S. Matsukura, N. Shimizu, and T. Nagashima Pituitary Somatotroph Adenoma Producing Growth Hormone (GH)-Releasing Hormone (GHRH) with an Elevated Plasma GHRH Concentration: A Model Case for Autocrine and Paracrine Regulation of GH Secretion by GHRH J. Clin. Endocrinol. Metab., September 1, 1999; 84(9): 3241 - 3247. [Abstract] [Full Text]