Journal of Clinical Endocrinology & Metabolism, Vol 68, 120-124, Copyright © 1989 by Endocrine Society

ARTICLES

Growth hormone deficiency in patients with idiopathic adrenocorticotropin deficiency resolves during glucocorticoid replacement

A Giustina, G Romanelli, R Candrina and G Giustina
Department of Internal Medicine, University of Brescia, Italy.

Glucocorticoids (GC) have stimulatory effects on GH secretion in vitro and suppressive effects when administered in pharmacological amounts in vivo. We studied six patients with ACTH deficiency and severely impaired serum GH responses to insulin tolerance tests and arginine infusion tests. All patients underwent the same tests during GC replacement while receiving cortisone acetate in doses ranging from 12.5-25 mg/day. The three patients with idiopathic ACTH deficiency and no evidence of pituitary mass lesions had impaired GH secretion, which returned to normal during GC replacement. In contrast, the three patients with ACTH deficiency and hypothalamo-pituitary mass lesions detected by a computed tomography scan had impaired GH secretion during GC replacement therapy. Our data indicate that in patients with idiopathic ACTH deficiency, an impaired GH response to stimuli reversible during GC replacement therapy may be the functional consequence of the low levels of circulating cortisol. We conclude that physiological serum cortisol levels are necessary for normal serum GH responses to provocative stimuli in man.

This article has been cited by other articles:

				E. Charmandari, S. M. Pincus, D. R. Matthews, A. Johnston, C. G. D. Brook, and P. C. Hindmarsh Oral Hydrocortisone Administration in Children with Classic 21-Hydroxylase Deficiency Leads to More Synchronous Joint GH and Cortisol Secretion J. Clin. Endocrinol. Metab., May 1, 2002; 87(5): 2238 - 2244. [Abstract] [Full Text] [PDF]

				A. Giustina, M. Gola, M. Doga, and E. A. Rosei Primary Lymphoma of the Pituitary: An Emerging Clinical Entity J. Clin. Endocrinol. Metab., October 1, 2001; 86(10): 4567 - 4575. [Full Text] [PDF]

				E. Charmandari, S. M. Pincus, D. R. Matthews, E. Dennison, C. H. D. Fall, and P. C. Hindmarsh Joint Growth Hormone and Cortisol Spontaneous Secretion Is More Asynchronous in Older Females Than in Their Male Counterparts J. Clin. Endocrinol. Metab., July 1, 2001; 86(7): 3393 - 3399. [Abstract] [Full Text] [PDF]

				J. A. Gusenoff, S. M. Harman, J. D. Veldhuis, J. J. Jayme, C. St. Clair, T. Munzer, C. Christmas, K. G. O'Connor, T. E. Stevens, M. F. Bellantoni, et al. Cortisol and GH secretory dynamics, and their interrelationships, in healthy aged women and men Am J Physiol Endocrinol Metab, April 1, 2001; 280(4): E616 - E625. [Abstract] [Full Text] [PDF]

				A.-C. A. R. Pinto, M. R. D. Silva, M. R. Martins, E. Brunner, and A.-M. J. Lengyel Effects of Short-Term Glucocorticoid Deprivation on Growth Hormone (GH) Response to GH-Releasing Peptide-6: Studies in Normal Men and in Patients with Adrenal Insufficiency J. Clin. Endocrinol. Metab., April 1, 2000; 85(4): 1540 - 1544. [Abstract] [Full Text]

				A. Giustina and J. D. Veldhuis Pathophysiology of the Neuroregulation of Growth Hormone Secretion in Experimental Animals and the Human Endocr. Rev., December 1, 1998; 19(6): 717 - 797. [Abstract] [Full Text]