Of the 430 children referred for the evaluation of short stature 100 (23%) were confirmed to have growth hormone deficiency. The male to female ratio was 1.94:1. Less than 10% belonged to the lower socio-economic group. Most of the cases (73%) presented between the ages of 6-15 years though growth failure was usually recognised earlier. Minimum of two stimulation tests were performed in each case. Seventy five GH deficient children had idiopathic GHD (IGHD) and 31% of these were familial. Fourteen had organic causes and 11 had GH resistance. Of 75 with IGHD, 18 had abnormal deliveries, breech or birth asphyxia. Multitropic pituitary hormone deficiency (MPHD) was found in 9/75 cases of idiopathic GHD and in three of the organic group. The height age was much more retarded than chronologic age in the GH resistant group (p less than 0.05) and the HA/BA ratio was also lowest in this group (p less than 0.001). Growth velocity was less than 4 cm/year in all the GHD children but was lowest in those with MPHD. The interesting feature of this study is the marked predominance of the familial cases 31% and a high incidence of growth hormone resistant cases (11%).
Ten children, five boys and five girls with true precocious puberty at an early age were found to have hypothalamic hamartomas on brain imaging. Very early onset of puberty, varying from a few weeks to three years of age, and rapid progression were characteristic. Accelerated growth velocity and markedly advanced bone age were evident in all. Gonadotropin and gonadal hormone levels were elevated above the prepubertal range. Six children had associated developmental delay or hyperactivity.
"Dlzbs-es Research LabwL::~i.s, &:cliffe Infinnuy, Oxford, LK. have studied phys1010~~1~31 g r o~t r , homne secretion i n 11 (6M, 5F) short prcrukrtal children, 4 % r;u@ 2.2-13.5 years, m t h psycho=lal dwarfism. A l l p7tlent.s were adxrittej t o haspltal, as a mre favourable en#mmmnt, as pu't of their rredlcal assessent m t h l l r r~t e d parental access. 5 tad been sexually abused which wd only dlscwered duri$-, t h~l r hsapital admission. An assesmnt of physiological m o n h homne secretion was canrr.ced m t h n 1 hour o f adnss~on. A second asse-went k -3 . 5 mde between 4 mr.1 9 days with a third assismnt at the end o f the 3 week adnusslon. A l l p i . . t h hon,mne s e m profiles were obtamed at 15 minute Intervals for 18 hours durrrtlcr &tween 1303 and 0700 hours. Mter stationxisation o f the profile data, amlysrs was by Fodmcr LransfomLion as a time series analysis to examine the frequency and a~plltude of p u t h homne pulses. Gmuth hotnnne lmufficlency ha2 ooserved dwlng Lhr-f i r s t day o f admsslon. ' h s was reversible d w i x Lhe 3 wselc; i n hospital, althok* Lhere was evidence that reversibility acclu.red m smc chlldrel mthin 18 hours o f admission to lhospital. Tne dammqt &?j-uut h honane srcrcLoy prrloilclty was ktween 120 and 165 mrmtes and show& no alteratlo" & r i n g Lne 3 sa7iplin.g accasions. However absolute s p e c t m power, hnicn reflect: the anlplituh of the oscillvtoly sigml, increased fm 45 t o 70 unlLs. &splLe charges I n -th b m n e pulse amplitude, profiles fm an individual chlld shswd ctwacterlstic "finger p r i n t i x " with a reproducible pattern o f pulses. I l r f l n d r g s dmnstrate m important aspects a b u t the 1nvesLiptlon of chlldren k i t h paychowial d w f i s m as well as contrlbutlng to OW kmowlejge of the pathophysioloa ofgro&h homne secretory dpmics. M A G N E T I C R E S O N A N C E I M A G I N G (MRI) I N PATIENTS W l T H M U L T I P L E PITUITARY H O R M O N E DEFICIENCIES (MPHD)M T h e a i m of this study w a s t o evaluate with magnetic resonance imaging (MRI) t h e hypothalamic a n d pituitary structures i n patients with idiopathic isolated g r o w l h h o r m o n e deficiency (GHD) o r multiple pituitary h o r m o n e deficiencies (MPHD).M R I w a s performed i n 1 6 pdtients with G H D (9 b o y s a n d 7 girls. a g e d 10.9 t o 16.9 years) w h o developped a normal puberly a n d 1 5 patients with MPHD ( 1 3 b o y s a n d 2 girls, a g e d 11.3 t o 2 5 years) including gonadotrophins deftciency.In 11115 M P H D patients a n ectopic, but normally a c t~v e , neurohypophys w a s detected, while i n t h e rematning 4 c a s e s the high intensity signal o f t h e neurohypophysis w a s absent. I n t h e 1 6 pattents with G H D . the signal of t h e neurohypophysis w a s normal. Moreover the pituitary height o n MRI, ranging from 1 to 5 m r n ( 2.80 k S E M 0.34 m m ) i n M P H D w a s significantly lower ( p c 0,0001) t h a n i n G H D patients ( 4.37 S E M 0.13 m m ).These results suggest that M R I i s useful in the investigation of idiopathic hypop...
A rerrasoeclive anaivsis of nubrrtal oaramelen of 30 children wlrh Crahn's disease (N=26) or a2 or Tvl 8 t o B Increase tsmlyrl (yrsl T V~ t o G: slsge 2.4 stage 2 -1 Girls:Nder N=l4 N=7 N=7 H=7 :Media0 12.6 :Range (9.8.13.951 1.17.3.78 4.4-15.88 5.8.12.96 :Standaid 11.2 2.0 13.3 8.2:p value 0.003 :p value 0.01 lnlest~nal resectLon (IR) was perlormul I n I I of lllcse prlienlr ('IM.7F) of wh
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