Effect of long‐term administration of recombinant human growth hormone (rhGH) on plasma erythropoietin (EPO) and haemoglobin levels in anaemic patients with adult GH deficiency

Sohmiya, Motoi; Kato, Yuzuru

doi:10.1046/j.1365-2265.2001.01417.x

Cited by 48 publications

(46 citation statements)

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“…EPO secretion is controlled mainly by oxygen pressure (Koury et al 1988, Eckardt et al 1989. We previously reported that plasma EPO levels increased after the start of rhGH infusion in anemic patients with chronic renal failure (Sohmiya et al 1998) and in adult patients with GH deficiency (Sohmiya & Kato 2001). Human plasma EPO levels increased within 6 h after the start of rhGH administration, suggesting that GH directly stimulates EPO production.…”

Section: Discussionmentioning

confidence: 99%

“…Although GH has a stimulatory effect on erythropoiesis, there have been few reports on the role of GH in EPO secretion. We previously reported that GH treatment increased plasma EPO levels in anemic patients with diabetic nephropathy (Sohmiya et al 1998) and in patients with GH deficiency (Sohmiya & Kato 2001). EPO is secreted from various organs depending on various conditions.…”

Section: Introductionmentioning

confidence: 99%

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Human growth hormone and insulin-like growth factor-I inhibit erythropoietin secretion from the kidneys of adult rats

Sohmiya

Kato²

2005

Journal of Endocrinology

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Growth hormone (GH) and insulin-like growth factor-I (IGF-I) play important roles in erythropoiesis and erythropoietin (EPO) secretion. We examined the effects of GH and IGF-I on EPO production in adult rat kidney and liver in vivo and in vitro. Male Wistar rats aged 8-10 weeks were used. Recombinant human GH (hGH) was continuously infused (20 µg/kg per h) subcutaneously for 48 h using a micro-osmotic infusion pump. Octreotide (10 µg/kg) was subcutaneously injected every 12 h beginning 12 h before the hGH treatment. GH increased plasma EPO levels earlier than it increased plasma IGF-I levels. At 24 h, the IGF-I content in the liver and kidney was increased from 172·8 14·6 to 232·6 17·8 ng/g tissue (means S.E.) and from 53·8 3·1 to 112·8 7·2 ng/g tissue, respectively. The EPO content in the liver was increased from 7·5 1·2 to 15·1 1·4 mIU/g tissue at 48 h, whereas the EPO content in the kidney was decreased at 12, 24, and 48 h after the start of hGH treatment. When the kidneys were organ-cultured, hGH considerably decreased EPO levels in the culture medium in a dose-related manner. The addition of anti-hGH IgG blunted the GH-induced inhibition of EPO secretion from the kidneys. IGF-I also decreased EPO levels in the medium in a dose-related manner. The addition of anti-IGF-I IgG blunted the IGF-I-induced inhibition of EPO secretion from the kidneys, whereas the GH-induced inhibition of EPO secretion was not affected. These findings suggest that both hGH and IGF-I have direct inhibitory effects on EPO secretion from adult rat kidneys.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Human growth hormone and insulin-like growth factor-I inhibit erythropoietin secretion from the kidneys of adult rats

Sohmiya

Kato²

2005

Journal of Endocrinology

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“…However, growth hormone replacement treatment in patients with growth hormone deficiencies has been shown to increase levels of erythropoietin, though the mechanism through which this occurs is unknown. 12 In vitro experiments have suggested that IGF-1 (under the control of growth hormone) leads to proliferation of immature erythroid colonies. 13 The hematopoietic changes described in animal models of hypopituitarism do not faithfully represent the human experience, and significant species-specific differences likely exist.…”

Section: Discussionmentioning

confidence: 99%

Hormones and the Bone Marrow: Panhypopituitarism and Pancytopenia in a Man with a Pituitary Adenoma

2015

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In rare cases, pancytopenia results from hormonal deficiencies that arise in the setting of panhypopituitarism. Here we describe the unusual case of a 60-year-old man who presented with progressive fatigue and polyuria, and whose laboratory workup revealed a deficiency of the five hormones associated with the action of the anterior pituitary (thyroid hormone, testosterone, cortisol, prolactin, and insulin-like growth factor-1). Imaging of the pituitary demonstrated a cystic mass consistent with a pituitary adenoma replacing much of the normal pituitary tissue. His symptoms and hematologic abnormalities rapidly resolved with prednisone and levothyroxine supplementati on. While the m ajority of r eported cases of panhypopituitarism with bone marrow suppression are the result of peripartum sepsis or hemorrhage leading to pituitary gland necrosis (Sheehan's syndrome), it is also important to consider the diagnosis of hypopituitarism in patients with hypothyroidism, low cortisol levels, and pancytopenia. The causal relationship between pancytopenia and panhypopituitarism is not well understood, though it does reinforce the important influence of these endocrine hormones on the health of the bone marrow. CASE PRESENTATIONA 60-year-old man was admitted to Massachusetts General Hospital with chest pain thought to be the result of his longstanding gastroesophageal reflux disease. He had a history of glaucoma, atypical nevi, and diverticulosis. He reported progressively worsening fatigue and weakness, a 10 lb weight loss, polyuria, and increased thirst. Laboratory testing on presentation was notable for hyponatremia (116 mmol/L) and pancytopenia. Out of concern for an underlying malignancy, the patient underwent contrast-enhanced computed tomography scans of the chest, abdomen, and pelvis, which were unremarkable. Given his progressive fatigue and hyponatremia, a morning serum cortisol level was checked and found to be very depressed (1.0 μg/dL; normal range 5-25 μg/dL). This prompted a more extensive endocrine evaluation (Table 1) that resulted in documentation of low levels of thyroid hormone, cortisol, testosterone, prolactin, and insulin-like growth factor-1 (IGF-1). A diagnosis of panhypopituitarism was made based on the reduced levels of all five hormones associated with the action of the anterior pituitary. A cosyntropin stimulation test demonstrated an inappropriately low increase in serum cortisol levels (1.2 to 7.4 μg/dL), suggesting reduced adrenal responsiveness due to prolonged adrenocorticotropic hormone (ACTH) deficiency. Though euvolemic, the patient displayed hyponatremia, with elevated urine osmolality, suggesting a component of elevated antidiuretic hormone (ADH) thought to be compensatory in the setting of glucocorticoid deficiency.In evaluation of the pituitary gland, MRI demonstrated a 6 mm cystic lesion in the posterior aspect of the pituitary (Fig. 1a). The radiologic appearance was most consistent with a cystic pituitary adenoma compressing and replacing the normal tissue of the pituitary gland. ...

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“…Steroid hormones directly stimulate erythropoiesis [13]. In addition, GH and IGF-1 are known to have a direct effect on erythroid and myeloid precursor progenitor cells [17,18].…”

Section: Discussionmentioning

confidence: 99%

Pancytopenia Associated with Hypopituitarism in an Acromegaly Patient: A Case Report and a Review of the Literature

et al. 2012

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We present the case of a patient with acromegaly who had pancytopenia with hypopituitarism secondary to the excision of a pituitary macroadenoma and radiation therapy. A 28-year-old man presented with pancytopenia and serum electrolyte abnormalities. He was diagnosed with acromegaly and underwent surgery and gamma-knife radiotherapy for a pituitary macroadenoma at the age of 22 years. A recent brain magnetic reso nance imaging showed an empty sella, and the basal hormonal profile demonstrated deficiencies of pituitary hormones except thyrotropin. As presenting pancytopenia, his bone marrow biopsy showed hypocellular marrow. The total number of hemocytes increased after hydrocortisone replacement. Hypopituitarism was a possible cause of pancytopenia, and glucocorticoids had crucial effects on converting pancytopenia to normal in this case. (Endocrinol Metab 27:308-313, 2012)

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Effect of long‐term administration of recombinant human growth hormone (rhGH) on plasma erythropoietin (EPO) and haemoglobin levels in anaemic patients with adult GH deficiency

Cited by 48 publications

References 34 publications

Human growth hormone and insulin-like growth factor-I inhibit erythropoietin secretion from the kidneys of adult rats

Human growth hormone and insulin-like growth factor-I inhibit erythropoietin secretion from the kidneys of adult rats

Hormones and the Bone Marrow: Panhypopituitarism and Pancytopenia in a Man with a Pituitary Adenoma

Pancytopenia Associated with Hypopituitarism in an Acromegaly Patient: A Case Report and a Review of the Literature

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