FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 309:1142-1146 November 10, 1983 Number 19 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

We studied insulin-like growth factors (IGF) I and II, prolactin, and the insulin response to arginine in 19 children with craniopharyngioma and documented growth hormone deficiency. Patients were divided into three groups according to their growth rate during the first postoperative year. Seven patients with excessive growth (Group A) had hyperinsulinism, normal IGF values, elevated basal prolactin levels, and a delayed thyrotropin response to thyrotropin-releasing hormone, which was compatible with hypothalamic lesions. In the six patients with normal growth (Group B), the insulin level was low; all other hormone values were similar to those of Group A. In the six patients with decreased growth (Group C), levels of IGF I, insulin, prolactin, and thyrotropin were low, indicating the presence of severe pituitary damage and explaining the failure to grow. Patients in all groups had low or undetectable basal levels of growth hormone. We conclude that in Group B, normal IGF permitted normal growth, and prolactin hypersecretion may have been responsible for normal IGF I values. Excessive growth in Group A may have been caused by hyperinsulinism associated with hyperphagia and obesity of hypothalamic origin.

This article has been cited by other articles:

• Geffner, M., Lundberg, M., Koltowska-Haggstrom, M., Abs, R., Verhelst, J., Erfurth, E. M., Kendall-Taylor, P., Price, D. A., Jonsson, P., Bakker, B. (2004). Changes in Height, Weight, and Body Mass Index in Children with Craniopharyngioma after Three Years of Growth Hormone Therapy: Analysis of KIGS (Pfizer International Growth Database). J. Clin. Endocrinol. Metab. 89: 5435-5440 [Abstract] [Full Text]  
• Harz, K. J., Muller, H. L., Waldeck, E., Pudel, V., Roth, C. (2003). Obesity in Patients with Craniopharyngioma: Assessment of Food Intake and Movement Counts Indicating Physical Activity. J. Clin. Endocrinol. Metab. 88: 5227-5231 [Abstract] [Full Text]  
• den Ouden, D. T., Kroon, M., Hoogland, P. H., Geelhoed-Duijvestijn, P. H. L. M., Wit, J. M. (2002). A 43-Year-Old Male with Untreated Panhypopituitarism due to Absence of the Pituitary Stalk: From Dwarf to Giant. J. Clin. Endocrinol. Metab. 87: 5430-5434 [Abstract] [Full Text]  
• Mason, P. W., Krawiecki, N., Meacham, L. R. (2002). The Use of Dextroamphetamine to Treat Obesity and Hyperphagia in Children Treated for Craniopharyngioma. Arch Pediatr Adolesc Med 156: 887-892 [Abstract] [Full Text]