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Biomedical subjects

R Illig

Publications and source records attributed to R Illig.

At least 37 records · Page 2Linked to original sources
PubMed1983

Thyroxine binding globulin radioimmunoassay in dried blood spotted on filter paper.

A method is described for the determination of thyroxine binding globulin (TBG) in dried blood spotted on filter paper using reagents from a test kit for the measurement of TBG in plasma. By minor modifications of the recommended procedure it was possible to improve precision, sensitivity and tracer displacement. Appropriate TBG standard samples were prepared in 'artificial blood' consisting of a suspension of erythrocytes in buffer with bovine serum albumin (50 milligrams). There is a good correlation between plasma TBG RIA results and blood spot TBG RIA results (r = 0.93). Attention must be paid to the stability of the TBG in blood: our experiments show a decrease of TBG content if filter paper cards with dried blood are stored longer than one month.

Blood Specimen Collection↗
PubMed1982

[Factitious hypoglycemia: clinical aspects, diagnosis and course in a non-diabetic male].

The case of a 37-year-old man without diabetes is reported who began to experience repetitive episodes of loss of consciousness. For 11/2 years the patient suffered from attacks of fatigue associated with sweating, tachycardia, blurred vision and finally unconsciousness. In the presence of low blood sugar and high plasma insulin values, an insulin producing pancreatic adenoma was initially suspected. In view of the negative results of radiological investigations, the different blood sugar reactions during fasting tests with and without supervision, together with low concentrations of C-peptide and high insulin values during various hypoglycemic episodes, factitious hypoglycemia was diagnosed. Finally, an ampoule of insulin was found in a locked suitcase of the patient. Therefore, in patients with fasting hypoglycemia as well as insulin producing adenoma, surreptitious insulin injections as part of a Müncchausen syndrome should be considered.

Adult↗
PubMed1982

Transient rise in luteinizing hormone and follicle stimulating hormone secretion during puberty studied in 113 healthy girls with tall stature.

To establish normal values for the LRH test in females around the age of puberty, we had the opportunity to study 113 health girls with tall stature. Plasma LH and FSH levels were determined before and after a bolus injection of LRH (25 microgram/m2). Hormone results could not be correlated with chronological age, bone age, height, weight, or public hair stages. However hormone results showed significant differences when grouped according to breast development and menarche. There was a continuous rise of gonadotropin levels, particularly of basal and peak LH values, in parallel with breast maturation, and a remarkable fall in girls after menarche when tested during the first half of the menstrual cycle. It appears that a transient rise in gonadotropin secretion is essential for the maturation of ovarian function, which, in turn, switches pituitary-gonadal regulation from the pubertal tonic to the adult cyclic type.

Body Height↗
PubMed1982

The use of a low-dose LHRH test for the distinction of delayed adolescence and isolated gonadotropin deficiency.

In order to evaluate the diagnostic usefulness of a low-dose LHRH test (LHRH HOE 471, bolus injection of 25 micrograms/m2 i.v.), we have reviewed the data of 30 boys with delayed growth and insufficient or lacking sexual development around the age of puberty, and of 8 boys with multiple pituitary hormone deficiencies. In 14 out of 22 boys with delayed adolescence, this diagnosis could be established on the basis of normal LH and FSH results; in 8 boys who also had a delayed but spontaneous pubertal development, gonadotropin response to LHRH was inadequate presumably due to a transiently reduced sensitivity of the "pituitary gonadotroph"; a second LHRH test carried out 12-32 months later revealed normal results. There is some evidence that exogenous or endogenous testosterone is important for the maturation of the adult gonadotropin secretion pattern. Eight patients with isolated true gonadotropin deficiency and all with idiopathic multiple pituitary hormone deficiencies had an insufficient gonadotropin response. This study shows that the low-dose LHRH test allows a good distinction between benign delayed adolescence and gonadotropin deficiency. False-negative results in some boys with delayed adolescence may be due to a decrease of pituitary responsiveness which will normalize with time.

Adolescent↗
PubMed1980

Success, relapse and failure after intranasal LHRH treatment of cryptorchidism in 55 prepubertal boys.

Synthetic LHRH was given intranasally to 55 prepubertal boys with 67 undescended testes. After a 4-5 week period while receiving a daily dose of 1.2 mg complete testicular descent was seen in 24 testes. Follow-up over 6 to 24 months showed relapse in 4 boys who responded successfully to a second trial with LHRH. In boys with insufficient or no response to an initial trial further treatment with LHRH in 11 cases or HCG in 5 cases also was without effect. Surgical correction after unsuccessful LHRH treatment in 32 boys with 35 undescended testes showed anatomical abnormalities in 28 testes, mostly an open processus vaginalis with or without hernia. Because of its simple and painless administration and the absence of unwanted side effects, intranasal LHRH is well-suited as initial treatment of cryptorchidism, particularly in young children.

Administration, Intranasal↗
PubMed1980

Effect of intranasal LHRH therapy on plasma LH, FSH and testosterone, and relation to clinical results in prepubertal boys with cryptorchidism.

Synthetic LHRH (HOE 471) administered intranasally over a period of 4 weeks for treatment of uni- or bilateral cryptorchidism in nineteen otherwise healthy prepubertal boys led to increased basal and peak LH values and to markedly decreased peak FSH values in the i.v. LHRH test. Basal testosterone remained unchanged. Sixteen cryptorchid boys treated with placebo served as a control group. The reduced FSH response to i.v. LHRH could be due to induction of a gonadal feedback mechanism rather than pituitary depletion of FSH, in view of the favourable therapeutic effect and the increased LH secretion seen in some of our patients. Pretreatment LHRH tests were available in twenty successfully and in twenty-eight unsuccessfully treated boys. LH values were similar in both groups, whereas FSH peak values were significantly higher in boys who responded successfully to subsequent therapy. Testicular descent occurred most readily in boys with a large pool of easily releasable FSH and without a significant rise in testosterone (in contrast to HCG treatment). We suggest that FSH induces changes that potentiate the local action of testosterone.

Administration, Intranasal↗
PubMed1980

Intellectual, school and occupational performance in patients with idiopathic hypothalamo-pituitary hypothyroidism and primary hypothyroidism.

Intelligence quotient (IQ), school and professional performance were reviewed in 33 patients with idiopathic hypothalamo-pituitary hypothyroidism. Diagnosis was based on low T4 values and clinical signs. All were treated with growth hormone (HGH). In some, hypothyroidism became manifest only after HGH therapy. Birth history revealed breech delivery in 24 and perinatal asphyxia in 15 of them. Thyroid treatment was started at a mean age of 9.8 (range 4-18 years). The mean IQ was 103.4 +/- 16.7 (SD). 9 patients had IQs below 90, 8 of them were born by breech delivery, 3 had severe perinatal asphyxia, one recurrent symptomatic hypoglycemia, and one a micropenis. Of those patients who have reached the respective age, 7 attended college, 3 university, and 9 had skilled professions. Only 7 required special education. For comparison, 52 patients with primary hypothyroidism were studied. Their mean IQ was with 89.3 +/- 18.1 (SD) significantly lower (p < 0.001) than the mean IQ of patients with hypothalamo-pituitary hypothyroidism. The best IQ (96.8 +/- 16.9) was attained when thyroid treatment was started before the age of 4 months, the lowest IQ (78.2 +/- 19.2) was found in the group of patients in whom thyroid substitution was initiated between 5 and 12 months. Patients who were treated after one year of age, had a mean IQ of 90.0 +/- 15.7. This group includes patients with ectopic thyroid glands or acquired hypothyroidism such as Hashimoto's thyroiditis.

Adolescent↗
PubMed1979

[Successful allotransplantation of an island of Langerhans].

Combined renal and pancreatic transplantation in patients with juvenile diabetes mellitus, diabetic nephropathy and renal insufficiency is designed to improve the poor prognosis observed with hemodialysis or renal transplantation alone. Interest has recently shifted from pancreatic organ to islet transplantation, in view of the absence of complications with the latter. However, no permanent success with islet transplants in diabetic patients has so far been reported. In the series presented, one patient with juvenile diabetes and subsequent renal failure was successfully treated with simultaneous kidney and intrasplenic pancreatic islet allotransplants. One year after the operation the patient has normal blood glucose levels without exogenous insulin, despite treatment with prednisone.

Adult↗
PubMed1979

Low urinary estriol during pregnancy caused by isolated fetal ACTH-deficiency.

In a 34-year-old pregnant woman, serum HPL and urinary HCG were normal, but urinary estriol was repeatedly low. A normal boy was delivered after 38 week gestation. During the neonatal period, he had hypoglycemia, muscular hypotonia and transient hyperbilirubinemia. The ACTH-test was normal, but the THS-response to metyrapone was low. Serum ACTH did not respond to insulin and metyrapone. Growth hormone, TSH and gonadotropin responses to stimuli were normal. Treatment with hydrocortisone resulted in disappearance of the symptoms. It is concluded that fetal ACTH-deficiency is one of the specific endocrine causes of low maternal estriol.

Adrenocorticotropic Hormone↗
PubMed1978

Endocrine studies in Fanconi's anaemia. Report of 4 cases.

Four boys with Fanconi's anaemia and growth hormone (GH) deficiency are reported. Case 1 had isolated GH deficiency and responded to HGH and to oxandrolone treatment. Case 2, his brother, had milder haematological and dysmorphic manifestations and maintained a low-normal growth rate without treatment in spite of laboratory evidence of GH deficiency. Case 3 had multiple hypothalamopituitary defects, including deficiencies of GH, ACTH, and gonadotrophins. Case 4 had isolated GH deficiency and responded moderately well to HGH treatment. 3 of the 4 patients had bilateral cryptorchidism, 2 with increased plasma gonadotrophins, indicating primary testicular failure. We conclude that GH deficiency, isolated or combined with other hypothalamopituitary defects, and primary testicular failure with cryptorchidism are frequent but not constant features of Fanconi's anaemia.

Anemia, Aplastic↗
PubMed1978

Pseudohypoparathyroidism and idiopathic hypoparathyroidism: relationship between serum calcium and parathyroid hormone levels and urinary cyclic adenosine-3',5'-monophosphate response to parathyroid extract.

Forty patients with hypocalcemia and/or Albright's hereditary osteodystrophy were studied. Based on the estimation of serum calcium and parathyroid hormone (PTH) levels as well as the urinary cAMP response to infusions with parathyroid extract, it was possible to classify all of the patients studied as cases with idiopathic hypoparathyroidism (n = 6, low PTH, normal cAMP response), pseudohypoparathyroidism (PHP) type I (n = 18, high PTH, low cAMP response) and type II (n = 2, high PTH, normal cAMP response), as well as pseudopseudohypoparathyroidism (n = 14, normal PTH, normal cAMP response). In three cases studied at the age of 12, 17, and 23 yr, the signs of Albright's hereditary osteodystrophy were not observed. PTH levels were unusually high for a given serum calcium concentration in some patients with PHP, the increased PTH levels were, however, normalized during iv calcium infusions. In two young children with PHP, a gradual increase of serum PTH levels occurred despite persistent normocalcemia over a period of 3 yr. This suggests that factors other than hypocalcemia or frequent small unobservable falls of the serum calcium concentration, such as a deficient formation of 1,25-dihydroxyvitamin D3, secretion of an abnormal PTH, or an abnormal metabolism of the hormone, may contribute to the secondary hyperparathyroidism in PHP.

Adolescent↗
PubMed1977

Treatment of cryptorchidism by intranasal synthetic luteinising-hormone releasing hormone. Results of a collaborative double-blind study.

The effect of intranasal luteinising-hormone releasing hormone (L.H.R.H.) in 84 boys with unilateral or bilateral cryptorchidism was evaluated in a double-blind controlled trial. Boys with retractile testes were not studied. L.H.R.H. caused no side-effects; plasma antibodies to L.H.R.H. were never demonstrated. Four weeks' therapy with intranasal L.H.R.H. administered in six doses daily (1.2 mg/day) led to complete descent in 38% of a total of 61 testes, an improved position in 28%, and no response in 19%; 15% of testes were never palpated. After placebo the position of 25% of testes was improved; there was no response in 75% of a total of 51 testes. The success-rate seemed to be independent of age, but was related to the initial testicular position, with complete descent in only 11% of testes not previously palpated compared with 48% of testes found in the inguinal region.

Administration, Intranasal↗