Biomedical subjects

M O Thorner

Publications and source records attributed to M O Thorner.

At least 127 records · Page 7Linked to original sources

PubMed1988

Intracellular calcium concentration and growth hormone secretion in individual somatotropes: effects of growth hormone-releasing factor and somatostatin.

The cytosolic free calcium concentration and cumulative GH release were measured simultaneously in normal pituitary cells. This was made possible by a novel combination of fluorescence microscopy using the calcium indicator fura-2 and a reverse hemolytic plaque assay. GRF (10 nM) rapidly increased the intracellular free calcium concentration ([ Ca2+]i) from a basal level of 234 +/- 17 nM (mean +/- SE) to a peak value of 480 +/- 61 nM 1 min after stimulation. This GRF-induced calcium rise was totally abolished in calcium-free medium or in the presence of calcium channel blockers cobalt chloride (2 mM) and verapamil (100 microM). When somatostatin (SRIF; 1 nM) was added after basal recordings, cytosolic calcium decreased to 96 +/- 23 nM in identified somatotropes. [Ca2+]i returned to baseline upon the removal of SRIF inhibition. This rebound was higher when a sequential treatment of SRIF followed by GRF was applied. Exposing cells to a combination of GRF (10 nM) plus SRIF (1 nM) resulted in a decrease in [Ca2+]i identical to that caused by SRIF treatment alone. Despite the 10-fold excess of GRF, SRIF not only inhibited hormone secretion, but also totally overcame the GRF-induced rise of [Ca2+]i. In summary, stimulation by GRF increases cytosolic calcium in normal somatotropes. This increase is proposed to be due to the influx of calcium through membrane ion channels. In contrast, SRIF decreases [Ca2+]i. This might explain the cAMP-independent effects of this peptide. The effect of SRIF dominates over that of GRF with respect to both changes in [Ca2+]i and hormone release. Changes in the GH secretory rate are, therefore, accompanied by parallel changes in [Ca2+]i, both of which are primarily regulated by SRIF.

Animals↗

PubMed1988

Effects of gonadal steroids on somatotroph function in the rat: analysis by the reverse hemolytic plaque assay.

The mechanism by which gonadal steroids modulate GH secretion is not known. We have used the reverse hemolytic plaque assay to examine whether gonadal steroid-induced modulation of GH secretion is effected by changes in the population of somatotrophs and/or alterations in their secretory properties. Two groups of Sprague-Dawley rats were studied: group 1 (n = 6) comprised male (M), castrate (Cx), and testosterone-replaced castrate male (Cx + T) rats and group 2 (n = 5) consisted of male (M), female (F), and 17 beta-estradiol-replaced castrate male (Cx + E) rats. The number of plaque-forming cells (expressed as both absolute number and a percentage of all cells) was determined, and secretory status was assessed by measuring plaque areas in response to 0, 0.01, 0.1, 1, 10, and 100 nM GHRH. While mean basal GH plaque areas were similar among the treatment groups of group 1, the maximal GH plaque area was significantly decreased in Cx [16.8 +/- 2.4 vs. 26.4 +/- 3.9 X 10(6) microns2 (mean +/- SEM); P less than 0.05], but not in Cx + T (27.5 +/- 4.1 microns2) rats. The GHRH EC50 was unaffected by castration or T replacement. The percentage and absolute population of somatotrophs were reduced in Cx, but not in Cx + T, rats, while the numbers of lactotrophs remained unchanged in these treatment groups. For group 2, the mean peak GH plaque area was reduced in Cx + E (16.5 +/- 2.9 microns2; P less than 0.001) compared to that in M rats (36.2 +/- 2.3 microns2), but was not significantly different from that in F (13.0 +/- 1.5 microns2) rats. The EC50 was significantly (P less than 0.025) greater in Cx + E (10.9 +/- 2.3 nM) and F (7.9 +/- 1.6 nM) compared to M rats (2.8 +/- 0.7 nM). The absolute somatotroph and lactotroph populations were increased in Cx + E compared to M and F rats, as were the populations of other pituitary cell types. Testosterone enhances GH secretion by increasing the secretory capacity, but not the sensitivity, of somatotrophs to GHRH and by recruiting the function of a subpopulation of somatotrophs. Estradiol reduces the secretory capacity and sensitivity of somatotrophs to GHRH, but increases the population of somatotrophs, lactotrophs, and non-GH- and non-PRL-secreting cells.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1988

A persistent pattern of varying pituitary responsivity to exogenous growth hormone (GH)-releasing hormone in GH-deficient children: evidence supporting periodic somatostatin secretion.

The pattern and degree of variation in pituitary responsivity to GHRH was examined in four GH-deficient children (two boys and two girls, aged 4 3/12 to 10 4/12 yr). All children were studied before and on multiple (three to six per child) occasions during long term GHRH therapy (1 or 2 micrograms/kg, sc, every 3 h) in an identical fashion. Each study comprised withdrawal of blood for serum GH measurements every 20 min between 2000 and 0800 h. All subjects received GHRH at 2000, 2300, 0200, and 0500 h as well as at 0800, 1100, 1400, and 1700 h throughout the long term treatment period (6-18 months). Although all children had low level (less than 7.0 micrograms/L) pulsatile GH secretion during baseline studies, the maximal peak values occurred at times other than 0500 h. Before GHRH treatment, serum GH levels rose significantly in response to 91% (62 of 68) of the GHRH doses administered. GH pulse amplitudes varied throughout the studies in all children, and this variability persisted despite 1300-3600 consecutive doses in each child. In all 17 study periods the highest serum GH concentration occurred shortly after the 0500 h GHRH dose. The mean peak GH concentration after the 0500 h GHRH dose [18.4 +/- 3.5 (+/- SE) micrograms/L] was significantly higher than those after the 2000 h (5.3 +/- 1.0 micrograms/L; P = 0.0001), 2300 h (7.4 +/- 2.1 micrograms/L; P = 0.0003), and 0200 h (10.9 +/- 2.5 micrograms/L; P = 0.011) doses. These results demonstrate that the responsivity of the pituitary to GHRH varies throughout the night in some GH-deficient children. There appears to be a direct relationship between the time of night and the degree of pituitary responsivity to GHRH. We suggest that this variable responsivity may be due to intermittent hypothalamic somatostatin secretion.

Child↗

PubMed1988

The somatotrope: an endocrine cell with functional calcium transients.

Growth hormone (GH) secretion by the somatotrope is under dual regulation by the hypothalamic peptides, somatostatin (SS) and GH-releasing hormone (GHRH). Cytosolic free calcium concentration and cumulative GH release were measured simultaneously in anterior pituitary cells from adult male rats. This was made possible using a combination of digital imaging video microscopy with the fluorescent calcium indicator Fura-2 and the reverse haemolytic plaque assay (RHPA) to identify the cell type and measure hormone secretion from the cells under study. This technique allows calcium measurements to be made at very short time intervals (less than 150 ms) in single cells. Spontaneous calcium transients were demonstrated in 85% of GH plaque-forming cells. These occurred at a frequency of 2-13 min-1 and had an amplitude of 50-500 nmoll-1. The somatotropes with the largest calcium fluctuations produced the largest plaques; thus, the calcium transients appeared to correlate with hormone release. Since the somatotrope alone shows these fluctuations, the mean intracellular calcium concentration is 238 +/- 18 nmoll-1 in somatotropes and 113 +/- 8 nmoll-1 in non-somatotropes. Upon exposure to SS (1 nmoll-1) intracellular calcium fell from 200-250 nmoll-1 to 50-100 nmoll-1 with an apparent reduction in oscillations. Withdrawal of SS increased the intracellular calcium level. GHRH increased intracellular calcium but 10 nmoll-1 GHRH given simultaneously with 1 nmoll-1 SS reduced intracellular calcium to that level observed during SS alone. Thus, the SS effect on intracellular calcium predominates. The effects of SS can be mimicked by removal of extracellular calcium, or by the addition of CoCl2 (2 nmoll-1) or by verapamil (100 mumoll-1), two agents which block calcium channels. The hormone secretion index (indicated by the area of the plaque formed in RHPA) enables us to demonstrate that GHRH in this system increases GH secretion, and SS inhibits it. In combination, GHRH and SS oppose one another. Spontaneous calcium oscillations are characteristic for normal somatotropes. These oscillations are related to spontaneous hormone secretion and due to influx of calcium through ion channels in the membrane. Intracellular signalling information may be encoded in both frequency and amplitude of calcium oscillations. The actions of GHRH and SS on regulation of GH secretion are proposed to be mediated, at least in part, by regulation of intracellular cytosolic free calcium. This modulation is dependent on extracellular calcium concentrations. We are now investigating the molecular mechanisms involved in this process.

Animals↗

PubMed1988

Therapeutic applications of bromocriptine in endocrine and neurological diseases.

Bromocriptine, or 2-bromo-alpha-ergocryptine, is a semisynthetic ergot alkaloid. The basis of its therapeutic application in endocrine and neurological diseases is its action as a potent dopamine agonist. Its ability to inhibit prolactin secretion has led to its successful use in suppression of puerperal lactation and in the treatment of pathological hyperprolactinaemia causing galactorrhoea, infertility or hypogonadism. It has been shown to be safe in pregnancy. The ability of bromocriptine to reduce the size of large prolactin-secreting pituitary tumours has resulted in the recovery of pituitary function and correction of visual field defects. Bromocriptine is less effective in acromegaly but is useful as adjuvant therapy to radiotherapy and/or surgery which has been the standard mode of treatment. It has been shown to be efficacious either alone or in combination with levodopa in the treatment of Parkinson's disease. Therapy with low doses appears to be effective and is associated with a significantly reduced incidence of side effects. The successful use of bromocriptine has also been reported for the treatment of non-functioning pituitary tumours, premenstrual syndrome, cyclical mastalgia, luteal phase insufficiency and portal-systemic encephalopathy, although its role in the treatment of these latter disorders remains uncertain until more extensive and adequately controlled trials have been conducted.

Bromocriptine↗

PubMed1988

Contemporary tools for the analysis of episodic growth hormone secretion and clearance in vivo.

The evaluation of episodic GH release is made difficult by the apparently random nature of GH secretory bursts, the frequent occurrence of minimally detectable plasma GH concentrations, the relatively rapid plasma disappearance rate of endogenous GH, and the large number of metabolic and environmental cues that alter GH dynamics. Nonetheless, the development of objective, statistically based, and reproducible computerized algorithms to quantify episodic GH release has offered new insights into the pathophysiological regulation of GH secretion in health and disease. Moreover, the recent formulation of algebraically explicit biophysical models of GH secretion and clearance has made possible a complete quantitative description of GH secretory and clearance dynamics over a full 24 hours of observation. Such analytical tools allow investigators to enumerate with statistically bounded confidence limits the number, amplitude, durations, and temporal locations of all significant underlying secretory bursts and simultaneously calculate the half-life of endogenous GH disappearance from all GH concentrations and their variances considered together. Accordingly, in conjunction with contemporary refinements in GH assay techniques, such novel approaches to dissecting the temporal structure of GH secretion and clearance in vivo should result in significantly enhanced understanding of GH dynamics in health and disease.

Child↗

PubMed1987

Growth hormone and prolactin responses to bolus and sustained infusions of GRH-1-40-OH in man.

To determine whether GRH stimulates PRL secretion we studied the effects of iv bolus injections and prolonged infusions of GRH 1-40-OH on PRL and GH serum levels in normal volunteers. Eight patients with acromegaly, two of whom had elevated basal levels of PRL, were also tested with single bolus injections. Six normal subjects given 3.3 micrograms/kg bolus injections of GRH showed a mean increment of GH of 22.0 +/- 1.7 ng/ml (mean +/- SE). A small rise in PRL was noted in 5 of the 6 subjects (mean peak level of 6.4 +/- 1.9 ng/ml vs basal level of 3.3 +/- 0.4 ng/ml, p less than 0.05). During the continuous intusion of GRH (10 ng/kg/min), GH levels rose gradually from a mean baseline of 1.1 +/- 0.1 ng/ml to a mean peak of 30.0 +/- 7.2 ng/ml at about 2 h and then slowly declined to a nadir of 4.2 +/- 0.4 ng/ml at 330 min. PRL levels did not rise significantly during the infusion. To determine whether the decline in GH levels in the face of continued infusion was due to loss of GH responsiveness, a 3.3 micrograms/kg bolus of GRH was given during the nadir at 330 min; this GH increment was significantly less than that obtained by the GRH bolus injection without the infusion (12.9 +/- 3.5 ng/ml vs 22.0 +/- 1.7 ng/ml, p less than 0.05). The PRL response to the GRH bolus was the same during the infusion of GRH as before. In each of 8 acromegalic patients (including two who had initially elevated basal PRL levels) GRH led to an increase in both GH and PRL levels. PRL and GH levels spontaneously fluctuated in parallel in 4 acromegalic cases studied with repeated samples over 6 h during placebo administration. These experiments show that GRH has significant, though weak, PRF effect in normals and that it is more potent PRF in acromegalic patients. Furthermore, the effects on GH and PRL of a sustained infusion of GRH for 5 1/2 h are both qualitatively and quantitatively different. These results suggest that the GRH effect is exerted either on different pituitary receptors for GH and PRL regulation, or that the releasable pools of the two hormones have different sizes and/or turnover times.

Acromegaly↗

PubMed1987

Actions of calcium ions and a calcium-influx blocker on basal and TRH- and GnRH-stimulated hormone release in patients with pituitary adenomas.

We investigated the influence of calcium ions on the secretion of anterior pituitary hormones basally and in response to exogenous hypothalamic releasing factors in 6 men with pituitary tumors. To this end, concentrations of LH, FSH, TSH, growth hormone and prolactin were measured in blood collected at 10-min intervals basally and during a continuous infusion of combined TRH (2 micrograms/min) and GnRH (1 microgram/min). Study sessions were randomized to iv saline, calcium, or diltiazem infusions or oral diltiazem administration. Our results indicate that in contrast to responses in normal men, iv calcium injections do not suppress circulating prolactin concentrations in patients with prolactin-secreting pituitary tumors. Moreover, neither oral diltiazem administration for one week nor acute iv diltiazem infusion suppressed the hyperprolactinemia of tumor patients. However, there were significant effects of drug and calcium treatments on serum concentrations of FSH, GH and testosterone, but not LH or TSH. Moreover, during GnRH-TRH stimulation, there were significant differences in LH, TSH, and testosterone responses in tumor patients compared to normal men. In summary, iv calcium infusion was associated with invariant basal release of anterior pituitary tumoral hormones in patients with pituitary adenomas. However, there were significant differences in the GnRH/TRH-stimulated release of certain anterior pituitary hormones in tumor patients compared to normal men in response to iv calcium and the calcium-channel antagonist, diltiazem.

Adenoma↗

PubMed1987

Selective beta 1-adrenergic receptor-blockade with atenolol enhances growth hormone releasing hormone and mediated growth hormone release in man.

The growth hormone (GH) responses to a single bolus injection of the growth hormone releasing hormone (GRH) were examined in the basal state and in the presence of beta-adrenergic receptor blocking agents of different specificity in ten normal men. During a constant five-hour infusion of 56 micrograms/min of propranolol (nonselective beta-adrenergic receptor-blocker) in seven subjects studied, there was a significant augmentation of the GH release in response to exogenous GRH compared to the GH response during saline infusion, as measured by the peak serum GH concentrations after GRH (P = 0.019) and the integrated GH values (P = 0.019). A similar significant enhancement of GH responses to exogenous GRH as compared to the control day was observed with the specific beta 1-adrenergic receptor-blocker atenolol in all seven subjects studied (four of whom also participated in the propranolol study). Both the peak GH response to a GRH bolus and the integrated GH values were significantly greater with atenolol (P = 0.019 for both). There was no difference in serum GH concentrations after beta-adrenergic receptor-blocking drugs during a three-hour sampling period before GRH administration compared to placebo. Our results support the concept that beta-adrenergic receptors may modulate either the release or action of hypothalamic somatostatin in the control of GH secretion in man. We suggest the effect is mediated by specific beta 1-adrenergic receptors.

Adrenergic beta-Antagonists↗

PubMed1987

Impact of intensive venous sampling on characterization of pulsatile GH release.

The effect of sampling intensity on quantitative properties of pulsatile growth hormone (GH) release was tested using an objective, statistically based pulse detection algorithm (Cluster). Seven normal young men had blood withdrawn at 5-min intervals for 24 h. The number of GH peaks/24 h (mean +/- SE) detected in the 5-min series (5.93 +/- 0.66) was significantly greater than the number of peaks documented in the constituent 10-min (3.45 +/- 0.28), 15-min (2.79 +/- 0.31), 20-min (2.86 +/- 0.64), 30-min (2.5 +/- 0.36), 45-min (2.21 +/- 0.21), and 60-min (1.93 +/- 0.23) series. The increased number of peaks detected with 5-min sampling reflected high-frequency pulsatile GH release occurring within the major GH secretory episodes. Both the mean widths and areas associated with peaks identified in the 5-min series were smaller than those documented with less intensive sampling. Peak amplitude did not change with sampling intensity. These data suggest that the major secretory episodes of GH release in normal young men encompass high-frequency GH secretory activity. That these high-frequency GH secretory events have not previously been described probably reflects the relatively infrequent sampling paradigms (e.g., every 20-30 min) commonly used in the past.

Adult↗

PubMed1987

Periodic interactions of GH-releasing factor and somatostatin can augment GH release in vitro.

Growth hormone (GH) is secreted as pulses in vivo. To understand the signals governing this periodicity, we have established a perifusion-based model of pulsatile GH release. Male rat anterior pituitaries were dispersed and perifused with pulses of human growth hormone-releasing factor-(1--40) (GHRF), with or without a continuous or discontinuous somatostatin tonus. An experiment was composed of a 1-h base-line collection followed by four 3-h cycles; each contained single or paired 10-min infusion(s) of 3 nM GHRF. In testing the impact of somatostatin, the protocol was identical except that 0.3 nM somatostatin was added 30 min into the base-line period and then was either continued throughout the study or withdrawn during the periods of GHRF infusion. GH base lines with somatostatin were lower than vehicle base lines (P less than 0.05). GHRF pulses generated consistent peaks of GH release between 200 and 300 ng. min-1. (10(7) cells)-1, and these peaks were not altered by continuous somatostatin. In contrast, withdrawal of somatostatin during GHRF administration elicited markedly higher GH peaks (P less than 0.05) and more total GH release (P less than 0.05). This response could not be accounted for by the additive effects of GHRF and somatostatin withdrawal.

Animals↗

PubMed1987

Actions of estradiol on discrete attributes of the luteinizing hormone pulse signal in man. Studies in postmenopausal women treated with pure estradiol.

We assessed the time-dependent impact of estradiol on properties of the luteinizing hormone (LH) pulse signal in 12 hypoestrogenemic postmenopausal volunteers studied basally and after 1, 5, 10, and 30 d of estradiol delivery via an intravaginal Silastic ring. Computerized analysis of the plasma LH time series revealed a significant decrease in LH pulse frequency within 24 h of estrogen treatment, followed by a secondary increase (days 5 and 10), and then a sustained decline (day 30) in LH pulsatility. Estradiol also significantly suppressed incremental and maximal (but not fractional) LH pulse amplitudes in a biphasic manner. In contrast, LH peak duration was invariant until day 30 of estradiol replacement. These observations indicate that the well recognized biphasic actions of estradiol on mean serum LH concentrations can be modeled in relation to specific and time-dependent alterations in LH pulse frequency and amplitude.

Administration, Intravaginal↗

PubMed1987

Effects of sex and age on the 24-hour profile of growth hormone secretion in man: importance of endogenous estradiol concentrations.

We undertook a study of the separate and combined effects of age and sex on the pulsatile pattern of GH secretion. The 24-h secretory profile of GH was generated by 20-min sampling in 10 young women (aged 18-33 yr), 10 young men (aged 18-33 yr), 8 postmenopausal women (aged greater than 55 yr), and 8 older men (aged greater than 55 yr). A computer-assisted pulse analysis program was used to assess both total GH secretion, as reflected in the 24-h integrated GH concentration (IGHC), and pulsatile secretion, as denoted by pulse frequency, duration, amplitude, and the fraction of GH secreted in pulses during the 24-h period (FGHP). IGHC was significantly greater in women than in men (P less than 0.025) and greater in the young than in the old (P less than 0.003). The mean pulse amplitude, duration, and FGHP were each greater in the young (P less than 0.006, P less than 0.03, and P less than 0.0001, respectively), but not significantly different between the sexes. The mean pulse frequency was not affected by sex or age. The serum concentration of free estradiol, but not free testosterone, correlated with IGHC (r = 0.46; P less than 0.005), pulse amplitude (r = 0.53; P less than 0.001), and FGHP (r = 0.59; P less than 0.0002). After correcting for the effects of estradiol, neither sex nor age influenced IGHC or mean pulse amplitude, while the effect of age on FGHP was reduced from 81% to 29%. Of the indices of GH secretion, FGHP had the strongest correlation (r = 0.43; P less than 0.006) with somatomedin-C. Somatomedin-C declined significantly with age in both sexes. Our results indicate that sex and age have independent and interrelated effects on GH secretion. These effects can be largely accounted for by corresponding variations in endogenous estradiol levels. These observations suggest an amplifying action of estradiol on the neuroendocrine regulation of pulsatile GH release.

Adolescent↗

PubMed1987

Role of dopamine in the regulation of growth hormone secretion: dopamine and bromocriptine augment growth hormone (GH)-releasing hormone-stimulated GH secretion in normal man.

The role of the dopaminergic system and its interaction with GH-releasing hormone (GHRH) in the regulation of GH secretion was investigated in normal men in two complementary studies. The men were given continuous iv infusions of 0.15 M saline (5 h), dopamine (4 micrograms/kg X min; 1 h), GHRH (2 ng/kg X min; 2 h), and GHRH (2 ng/kg X min; 2 h) plus dopamine (4 micrograms/kg X min; 1 h) on four separate occasions, and serum GH responses were measured. In a second study, on separate days, placebo or bromocriptine (2.5 mg/dose) was administered, and GH and PRL responses to a single iv GHRH dose were measured. A continuous infusion of dopamine and GHRH on separate days stimulated GH secretion in all subjects. The mean integrated GH secretion was 13.2 +/- 3.1 (+/- SEM) ng/mL X h during the dopamine infusion and 14.7 +/- 4.6 during GHRH, compared with 1.7 +/- 0.4 during the saline infusion. The combination of GHRH and dopamine resulted in the greatest stimulation of GH secretion (29.8 +/- 5.7 ng/ml X h; P less than 0.05 vs. 3 other study days). The oral dopamine agonist bromocriptine also augmented GHRH-stimulated GH secretion. Integrated GH secretion after a single iv injection of GHRH following two doses of bromocriptine was 160 +/- 29.5 ng/ml X h compared with 81.3 +/- 22.2 after placebo (P = 0.04). We suggest that these findings are compatible with the hypothesis that dopamine inhibits hypothalamic somatostatin secretion, which then allows for a greater stimulatory effect of GHRH.

Adult↗

PubMed1987

Pituitary response to intravenous hypothalamic releasing peptides in cynomolgus monkeys treated with contraceptive steroids.

The secretory response of the pituitary to an iv bolus dose of hypothalamic releasing peptides (HRP) was evaluated in male and cycling (CYC) or contraceptive-treated female cynomolgus monkeys. Parenteral delivery of levonorgestrel and 17 beta-estradiol by intravaginal ring (CVR) was compared with oral administration (OC) of norgestrel and ethinyl estradiol in the diet. LH secretion was suppressed in the CVR group compared to that in other groups, and the response in males was greater than that in either CYC or OC females (P less than 0.01). Elevated plasma PRL concentrations in the CVR group during the baseline period (P less than 0.05) together with their larger pituitary weights (P less than 0.01) suggested lactotroph hypertrophy or hyperplasia compared to other groups. The plasma GH response was similar in the male, CYC, and CVR groups, but plasma GH levels increased from -15 to 0 min before HRP injection in the OC group (P less than 0.001) and continued to be higher for 15 min after HRP compared to values in the other groups (P less than 0.001), suggesting a treatment effect. Neither plasma TSH nor T4 levels were different among the groups after HRP administration, but T4 was elevated (P less than 0.01) in the OC group due to increased T4-binding globulin. The greater ACTH response 15 min after HRP treatment (P less than 0.05) in the CVR group compared to that in the other groups was associated with greater adrenal weights of the CVR females (P less than 0.05), suggesting chronic tropic stimulation. However the adrenal steroid results did not support this interpretation. We conclude that the differences in pituitary hormone secretion during these studies could be attributed to the nature of the reproductive steroid environment.

Adrenocorticotropic Hormone↗

PubMed1987

Ectopic pituitary gland simulating a suprasellar tumor.

A case report of ectopic pituitary gland in the suprasellar region of a normal 39-year-old woman with persistent headaches is presented. The embryological development of the pituitary gland is briefly reviewed, with a discussion of the relevant literature. No previous report of normal pituitary tissue in a suprasellar location in the absence of tumor could be found.

Adult↗

PubMed1987

Pancreatic endocrine tumour producing growth hormone-releasing hormone associated with multiple endocrine neoplasia type I syndrome.

We report the first documentation of GHRH production by a tumour associated with proven multiple endocrine neoplasia (MEN). A 30-year-old woman had hypoglycaemia, hyperparathyroidism, and pituitary adenoma with hyperprolactinaemia. Serum growth hormone elevation was attributed to hypoglycaemia but plasma GHRH was elevated. Subtotal pancreatectomy revealed multiple endocrine tumours and nesidioblastosis. Immunohistochemistry demonstrated insulin, glucagon, and somatostatin in several tumours. GHRH was localized in the largest one and was released from that tumour in vitro. Post-operative plasma GH returned to normal. Excess secretion of humoural factors by one tumour may stimulate growth of other tumours in MEN syndromes. The prevalence of GHRH in MEN-I tumours remains to be established.

Adult↗

PubMed1987

Prolactinomas.

Prolactin-secreting pituitary tumors are not rare. The diagnosis of a patient with hyperprolactinemia and possible tumor should be carried out in an orderly fashion by first excluding secondary causes. If the patient has pathologic hyperprolactinemia, assessment of pituitary anatomy with a high resolution CT scan (or MRI) should be done. In patients who have a macroadenoma, quantitative visual field examination should be a part of the ophthalmologic examination. The choice of therapy is dependent on the clinical findings, the risks of therapy, and patient preference. Currently, the most effective therapy for a patient with a macroadenoma is medical therapy with a dopamine agonist, but this must be given chronically. Regardless of the therapy selected, these patients must be followed regularly. Once fertility is established, there is usually no contraindication to pregnancy in women who wish to become pregnant.

Diagnosis, Differential↗