PEDIATRICS Vol. 39 No. 6 June 1967, pp. 844-852
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THE PLASMA GROWTH HORMONE RESPONSE TO INSULIN-INDUCED HYPOGLYCEMIA IN CHILDREN WITH RETARDATION OF GROWTH

Allen W. Root M.D.1, Robert L. Rosenfield M.D.1, Alfred M. Bongiovanni M.D.1, and Walter R. Eberlein M.D.1

1 The Department of Pediatrics, University of Pennsylvania School of Medicine and the Children's Hospital of Philadelphia, Philadelphia

The response of plasma growth hormone (HGH) concentration to insulin-induced hypoglycemia has been assessed in children with growth disturbances of varied etiology. In normal children and in patients with genetic short stature, constitutional delay in growth and development, Down's syndrome, Turner's syndrome, and glucocorticoid-induced growth retardation, plasma HGH concentration increased several fold following the administration of insulin.

In patients with hypopituitarism of unknown etiology and in four of six patients with hypopituitarism secondary to a craniopharyngioma, HGH concentration did not increase significantly in response to the hypoglycemic stimulus. In two patients with hypopituitarism secondary to craniopharyngioma, low concentrations of HGH were detectable but did not increase in response to the hypoglycemic state. Remnants of autonomously functioning pituitary tissue most probably explain this observation. Normal HGH responsivenesss was observed in children with vasopressin sensitive diabetes insipidus.

Three children with hypothyroidism had abnormal HGH responsiveness, which improved following restoration of the euthyroid state. Pituitary and/or hypothalamic myxedema may be responsible for the decreased responsiveness.

It is suggested that the control of growth hormone secretion in the young, growing child differs quantitatively from that of the adult subject.

Submitted on November 4, 1966
Accepted on January 3, 1967




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