A single im injection of 1500 IU hCG significantly increased plasma testosterone levels for at least 96--120 h in normal men (n = 7), patients with isolated gonadotropin deficiency (n = 6), and boys with delayed puberty (n = 7); the maximum values [1315 +/- 309, 370 +/- 177, and 963 +/- 249 ng/100 ml (mean +/- SD), respectively] were achieved after 72 h in each group. Repeated daily injections of 1500 IU hCG for 3 days increased plasma testosterone levels in the same subjects at 72 h after the start to levels (1342 +/- 412, 407 +/- 199, and 1052 +/- 449 ng/100 ml, respectively) similar to those found in the single dose experiment. The levels achieved at 24 and 48 h also did not differ significantly in the two experiments. The data indicate the lack of additional leydig cell stimulation by repeated hCG injections given within 48 h after a single dose.
The present report concerns a 10-year-old boy in whom diabetes insipidus and short stature were the first manifestations of a suprasellar germinoma. Neuroradiological investigations performed when these symptoms appeared were negative. 2 years later, a rapid and early pubertal development was observed and related to secretion by the germinoma of human chorionic gonadotropin (hCG) identified immunohistochemically. This clinical evolution is unusual and indicates that plasma hCG measurements in patients with so-called idiopathic diabetes insipidus can be of clinical value in predicting the presence of an hCG-secreting tumor.
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