Russell-Silver Syndrome and Pituitary Gonadal Axis Dysfunction

Sir.—We read with interest the article "Russell-Silver Syndrome [RSS] and Hypopituitarism" by Cassidy et al,¹ who pointed out the importance of the endocrinologic examination in patients with RSS. The association of endocrinologic abnormalities and RSS has not been well recognized. We have seen seven patients with RSS, with a mean follow-up period of six years. Of these seven patients, three (two boys and one girl) had abnormal endocrinologic data, while the other four did not. Levels of luteinizing hormone and folliclestimulating hormone under basal conditions and after administration of luteinizing hormone—releasing hormone (2 μg/kg by intravenous injection) in three patients with Russell-Silver syndrome. Shaded area represents responses in normal subjects at ages 5 to 10 years. Patients 1 and 2 were boys; patient 3 was a girl.

Patient 1 Patient 2 Patient 3 0 30 60 120 Time Elapsed, min Patient 1 Patient 2 Patient 3 0 30