4 patients with presumed pituitary hypothalamic sarcoidosis are described. 3 had histological diagnoses compatible with sarcoidosis and in the other this diagnosis was strongly suspected from chest X-rays. 2 patients presented with diabetes insipidus. ACTH reserve was diminished in 3 out of 4 and growth hormone reserve was diminished in the 3 who were tested. All 4 patients developed secondary amenorrhea. 3 patients had hypothalamic hypothyroidism. Prolactin dynamics were intact. Tomograms of the sella turcica in all 4 and computerized tomography of the hypothalamic area in 2 patients failed to reveal any abnormality.

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Employing a sensitive competitive protein binding assay for NSILA (non-suppressible insulin-like activity), circulating levels of this somatomedin (SM) have been measured throughout pregnancy, at parturition, and in foetal and newborn sera. Acid-dissociable serum NSILA (mean \ m=+-\ sem) in 57 women was significantly higher during pregnancy (1106 \m=+-\46 \g=m\U/ml), than in 11 adult non-pregnant control subjects (844 \ m=+-\ 22 \g=m\U/ml), but not correlated with week of gestation or with serum growth hormone (GH) or cortisol levels. At parturition, the NSILA concentration in 28 cord sera (598 \m=+-\38 \g=m\U/ml) was significantly less than in the corresponding maternal sera (1039 \m=+-\63 \g=m\U/ml). The NSILA levels in 23 premature newborns (370 \m=+-\ 20 \g=m\U/ml) and 8 smallfor-gestational-age newborns (310 \m=+-\46 \g=m\U/ml) were significantly less than in 33 term newborns (494 \m=+-\18 \g=m\U/ml). Serum NSILA in 56 term and premature newborns exhibited a significant positive correlation both with gestational age and birth weight but not with serum GH or cortisol levels. These data suggest that the maternal-foetal growth-promoting system is a highly complex one in which NSILA levels both in maternal and foetal circulations appear to be\ under multifactorial control.

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