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September 1973, Vol 126, No. 3 >
Article | September 1973

Growth Hormone in Marasmus Due to Cerebral Disease FREE

Edmund Kerpel-Fronius; Gábor Gács; Charlotte Hervei
[+] Author Affiliations

Received for publication Jan 4, 1973; accepted April 5.

Reprint requests to Department of Pediatrics No. II, Semmelweis University Medical School, Budapest IX, Tüxoltó u 7-9, Hungary (Mr. Kerpel-Fronius).


Am J Dis Child. 1973;126(3):303-309. doi:10.1001/archpedi.1973.02110190265004.
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References
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In two cases of diencephalic syndrome with emaciation, very high fasting levels of plasma growth hormone (GH) were consistently found. Insulin injection and arginine hydrochloride stimulation did not always raise the hormone levels, and glucose loading resulted in incomplete suppression. Plasma insulin response to arginine stimulation and to glucose loading was blunted. Despite the presence of acromegalic levels of GH in the blood, longitudinal growth became as stunted as in other forms of malnutrition.

To study the relative roles of cerebral damage and malnutrition, the same investigations were carried out in other groups of patients. High plasma GH levels were only found during manifest hypoglycemia or hypoproteinemia, and in one case of cerebral damage complicated by malnutrition and hypertonic dehydration.

REFERENCES

1 +
Russel A:  A diencephalic syndrome of emaciation in infancy and childhood . Arch Dis Child 26:774-784, 1951;.
2 +
Smith KR, Weinburg WA, McAlister WH:  Failure to thrive: The diencephalic syndrome of infancy and childhood . J Neurosurg 23:348-351, 1965;.
3 +
Conte FA, et al:  Growth hormone secretion in cachexia . J Pediatr 69:969-970, 1966;.
4 +
Beck P, Parker ML, Daughaday WH:  Paradoxical hypersecretion of growth hormone in response to glucose . J Clin Endocrinol Metab 26:463-469, 1966;.
5 +
Fishman MA, Peake GT:  Paradoxical growth in a patient with the diencephalic syndrome . Pediatrics 45:973-982, 1970;.
6 +
Pimstone BL, et al:  Secretion of growth hormone in the diencephalic syndrome of childhood . J Pediatr 76:886-889, 1970;.
7 +
Herbert V, Lauk GCV, Blücher SJ:  Coated charcoal immunoassay of insulin . J Clin Endocrinol 25:1375-1381, 1965;.
8 +
Laurell S, Tibbling G:  Colorimetric microdetermination of free fatty acids in plasma . Clin Chim Acta 16:57-62, 1967;.
9 +
Godard C, Zahnd GR:  Growth hormone in severe infantile malnutrition: I. Plasma growth hormone response to hypoglycemia. II. Plasma insulin and growth hormone during intravenous glucose tolerance test . Helv Paediatr Acta 26:266, 276-285, 1971;.
10 +
Pimstone BL, et al:  Growth hormone and kwashiorkor: Role of protein in growth hormone homeostasis . Lancet 2:779-780, 1966;.
11 +
Hadden DR:  Glucose, free fatty acid and insulin interrelations in kwashiorkor and marasmus . Lancet 2:589-592, 1967;.
12 +
Milner RDG:  Metabolic and hormonal response to glucose and glucagon in infantile malnutrition . Pediatr Res 5:33-39, 1971;.
13 +
Beas F, et al:  Plasma growth hormone levels in severe infantile malnutrition , abstracted. J Pediatr 77:721, 1970;.
14 +
Cahill GF Jr, et al:  Hormone-fuel interrelationships during fasting . J Clin Invest 45:1751-1769, 1966;.
15 +
Felig P, et al:  Amino acid metabolism during prolonged starvation . J Clin Invest 48:584-594, 1969;.
16 +
Powel GF, et al:  Emotional deprivation and growth retardation simulating idiopathic hypopituitarism: II. Endocrinic evaluation of the syndrome . N Engl J Med 276:1279-1283, 1967;.
17 +
Trenkle A:  Effect of starvation on pituitary and plasma growth hormone in rats . Proc Soc Exp Biol Med 135:77-80, 1970;.
18 +
Sorrentino S Jr, Reiter RJ, Schalch DS:  Interactions of the pineal gland, blinding and underfeeding on reproductive organ size and radioimmunoassayable growth hormone . Neuroendocrinol 7:105-115, 1971;.
19 +
Becker DJ, et al:  Serum albumin and growth hormone relationships in kwashiorkor and the nephrotic syndrome . J Lab Clin Med 78:865-871, 1971;.
20 +
Whitehead RG, Coward WA, Lunn PG:  Serum albumin concentration and the onset of kwashiorkor . Lancet 1:63-66, 1973;.
21 +
Finberg L, Luttrell C, Redd H:  Pathogenesis of lesions in the nervous system in hypernatremic states: I. Clinical observations of infants. II. Experimental studies of gross anatomic changes and alterations of chemical composition of the tissues . Pediatrics 23:1, 40-45, 1959;.
22 +
Beck P, et al:  Correlative studies of growth hormone and insulin plasma concentrations with metabolic abnormalities in acromegaly . J Lab Clin Med 66:366-379, 1965;.
23 +
Frasier SD, Kogut MD:  Adolescent acromegaly: Studies of growth hormone and insulin metabolism . J Pediatr 71:832-839, 1967;.

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References

1 +
Russel A:  A diencephalic syndrome of emaciation in infancy and childhood . Arch Dis Child 26:774-784, 1951;.
2 +
Smith KR, Weinburg WA, McAlister WH:  Failure to thrive: The diencephalic syndrome of infancy and childhood . J Neurosurg 23:348-351, 1965;.
3 +
Conte FA, et al:  Growth hormone secretion in cachexia . J Pediatr 69:969-970, 1966;.
4 +
Beck P, Parker ML, Daughaday WH:  Paradoxical hypersecretion of growth hormone in response to glucose . J Clin Endocrinol Metab 26:463-469, 1966;.
5 +
Fishman MA, Peake GT:  Paradoxical growth in a patient with the diencephalic syndrome . Pediatrics 45:973-982, 1970;.
6 +
Pimstone BL, et al:  Secretion of growth hormone in the diencephalic syndrome of childhood . J Pediatr 76:886-889, 1970;.
7 +
Herbert V, Lauk GCV, Blücher SJ:  Coated charcoal immunoassay of insulin . J Clin Endocrinol 25:1375-1381, 1965;.
8 +
Laurell S, Tibbling G:  Colorimetric microdetermination of free fatty acids in plasma . Clin Chim Acta 16:57-62, 1967;.
9 +
Godard C, Zahnd GR:  Growth hormone in severe infantile malnutrition: I. Plasma growth hormone response to hypoglycemia. II. Plasma insulin and growth hormone during intravenous glucose tolerance test . Helv Paediatr Acta 26:266, 276-285, 1971;.
10 +
Pimstone BL, et al:  Growth hormone and kwashiorkor: Role of protein in growth hormone homeostasis . Lancet 2:779-780, 1966;.
11 +
Hadden DR:  Glucose, free fatty acid and insulin interrelations in kwashiorkor and marasmus . Lancet 2:589-592, 1967;.
12 +
Milner RDG:  Metabolic and hormonal response to glucose and glucagon in infantile malnutrition . Pediatr Res 5:33-39, 1971;.
13 +
Beas F, et al:  Plasma growth hormone levels in severe infantile malnutrition , abstracted. J Pediatr 77:721, 1970;.
14 +
Cahill GF Jr, et al:  Hormone-fuel interrelationships during fasting . J Clin Invest 45:1751-1769, 1966;.
15 +
Felig P, et al:  Amino acid metabolism during prolonged starvation . J Clin Invest 48:584-594, 1969;.
16 +
Powel GF, et al:  Emotional deprivation and growth retardation simulating idiopathic hypopituitarism: II. Endocrinic evaluation of the syndrome . N Engl J Med 276:1279-1283, 1967;.
17 +
Trenkle A:  Effect of starvation on pituitary and plasma growth hormone in rats . Proc Soc Exp Biol Med 135:77-80, 1970;.
18 +
Sorrentino S Jr, Reiter RJ, Schalch DS:  Interactions of the pineal gland, blinding and underfeeding on reproductive organ size and radioimmunoassayable growth hormone . Neuroendocrinol 7:105-115, 1971;.
19 +
Becker DJ, et al:  Serum albumin and growth hormone relationships in kwashiorkor and the nephrotic syndrome . J Lab Clin Med 78:865-871, 1971;.
20 +
Whitehead RG, Coward WA, Lunn PG:  Serum albumin concentration and the onset of kwashiorkor . Lancet 1:63-66, 1973;.
21 +
Finberg L, Luttrell C, Redd H:  Pathogenesis of lesions in the nervous system in hypernatremic states: I. Clinical observations of infants. II. Experimental studies of gross anatomic changes and alterations of chemical composition of the tissues . Pediatrics 23:1, 40-45, 1959;.
22 +
Beck P, et al:  Correlative studies of growth hormone and insulin plasma concentrations with metabolic abnormalities in acromegaly . J Lab Clin Med 66:366-379, 1965;.
23 +
Frasier SD, Kogut MD:  Adolescent acromegaly: Studies of growth hormone and insulin metabolism . J Pediatr 71:832-839, 1967;.

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