Disease relevance of Hypothalamic Diseases

• The increase after hpGRF-40 in serum GH levels in this patient and the similar or greater responses in 3 of 7 patients suggest that at least some of these patients may have hypothalamic GH-releasing-hormone deficiency. hpGRF-40 may be useful in distinguishing pituitary disease from hypothalamic disease [1].
• Patients who have severe hypogonadotropic hypogonadism caused by presumed hypothalamic disease often have a subnormal LH response to a bolus dose of gonadotropin-releasing hormone (GnRH) [2].
• The magnitude of the hypopituitarism was less in the three patients whose anterior pituitary remnant was greater than 2 mm, and in them, TRH testing resulted in exaggerated TSH and PRL responses, suggestive of hypothalamic disease [3].
• Mean PRL response to both drugs was significantly lower in all groups of patients than in controls, and significantly higher in subjects with idiopathic hyperprolactinemia than in those with pituitary adenomas or hypothalamic disease [4].
• Because radioimmunoassayable prolactin concentrations are infrequently elevated in patients with disseminated sarcoidosis, even when pitutitary hypofunction is apparent, it is concluded that the measurement of serum prolactin is not a reliable method for screening these patients for pituitary or hypothalamic disease [5].

High impact information on Hypothalamic Diseases

• The defect in ACTH secretion was apparently due to intrinsic pituitary rather than hypothalamic disease, because administration of lysine vasopressin did not stimulate ACTH release [6].
• It was not possible to differentiate patients as having pituitary or hypothalamic disease based solely on the TRH test results [7].
• This may be due to NTI per se, drugs administered for treatment of NTI, or associated pituitary or hypothalamic disease; the latter consideration may require evaluation of cortisol reserve, PRL, and/or gonadotropins [8].
• If this were the case, the dynamics of PRL secretion in this instance would be similar to those in patients with stalk section, dopamine deficiency, or hypothalamic disease [9].
• There was no systematic increase in ob-expression in obese children with hypothalamic disease compared to their healthy brothers and sisters [10].

Chemical compound and disease context of Hypothalamic Diseases

• A low serum testosterone concentration associated with a serum LH concentration that is not high, on the other hand, indicates secondary hypogonadism, the result of pituitary or hypothalamic disease [11].
• This combination of abnormalities is attributable to hypothalamic disease and has not to our knowledge been previously reported with clearly documented antidiuretic hormone excess [12].

Gene context of Hypothalamic Diseases

• OBJECTIVE: Insulin-induced hypoglycaemia is the standard method for assessment of the hypothalamo-pituitary-adrenal (HPA) axis of patients with pituitary or hypothalamic disease [13].
• These are the transient DI syndromes due either to subclinical hypothalamic disease or to a disorder peculiar to pregnancy which is AVP-resistant but dDAVP-responsive; the latter analogue resists degradation by vasopressinase [14].

Analytical, diagnostic and therapeutic context of Hypothalamic Diseases

• DESIGN: A randomized double-blind study comparing 6 months GH replacement with placebo in adults with GH deficiency due to pituitary or hypothalamic disease [15].

References