A 38-year-old man had an acute onset of consciousness loss, pyrexia and hyponatremia. Plasma Adrenocorticotropic Hormone (ACTH)and cortisol levels were low. Plasma ACTHfailed to respond to corticotropin-releasing hormone (CRH)and insulin-induced hypoglycemia whereas i.m. injection of ACTH-Zraised plasma cortisol. Plasma insulin-like growth factor-I (IGF-I) and urine growth hormone (GH) concentrations were also low and plasma thyroid-stimulating hormone(TSH) level was rather elevated. Plasma IGF-I and TSHlevels were not completely normalized by glucocorticoid (GC) replacement alone although plasma GHresponses to pharmacological stimuli were normalized. The GCreplacement in combination with daily s.c. injection of recombinant human GH(rhGH) not only normalized plasma IGF-I and IGFBP-3 levels, but also further lowered the plasma TSHlevel, possibly due to an increased T4/T3 conversion, which resulted in a beneficial change in body composition. (Internal Medicine 34: 688-691, 1995)
The effects of continuous subcutaneous infusion (CSI) of human granulocyte-colony stimulating factor (G-CSF) on the absolute neutrophil count (ANC) and serum G-CSF level were examined in 11 patients with non-Hodgkin's lymphoma (NHL) during cytotoxic chemotherapy. Recombinant G-CSF (rG-CSF) was subcutaneously infused using a portable infusion pump at a constant flow rate of 1 microgram/20 microliters/h for 14 days starting 2 days after the end of the second course of chemotherapy. The ANC was lowered after the chemotherapy without rG-CSF infusion whereas the duration of neutropenia and the nadir level of the ANC after the chemotherapy were ameliorated by the combined administration of rG-CSF (mean +/- S.E., 0.6 +/- 0.5 days vs. 4.7 +/- 1.9 days, P< 0.05; 455 +/- 135/microliter vs. 1906 +/- 598/microliter, P < 0.05). Serum G-CSF levels increased after the start of rG-CSF infusion, reaching a mean peak value of 418.5 +/- 128.5 pg/ml at the 8th day, and then returned to the basal level (35.6 +/- 13.5 pg/ml) immediately after the end of continuous infusion of rG-CSF. Although a slight increase in serum G-CSF was obtained in the patients after the chemotherapy without rG-CSF administration, the mean serum level was much lower than that in the patients after the chemotherapy with rG-CSF administration (88.2 +/- 24.8 pg/ml vs. 199.6 +/- 20.6 pg/ml, P < 0.01). No notable side effects of the CSI of rG-CSF were noted.(ABSTRACT TRUNCATED AT 250 WORDS)
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