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Abstract
All fifteen patients (twelve hypopituitary dwarfs, one primordial dwarf and two patients with gonadal dysgenesis) studied exhibited one or another metabolic response to human growth hormone (HGH) during initial short-term studies. Decreased urinary nitrogen, increased urinary calcium and increased urinary hydroxyproline: creatinine ratio were observed in all patients so studied. All twelve hypopituitary dwarfs showed a significant fall in serum urea nitrogen. The magnitude of the various responses to HGH varied in individual patients. No effect of the short-term administration of HGH could be used to predict the response in linear growth to prolonged therapy with the possible exception of minimal nitrogen retention (< 1.0 gm. per day).
The data presented here suggest that the administration of HGH, 5 mg. daily for six days, will correct reactive hypoglycemia but that a longer period of treatment is necessary for correction of sensitivity to exogenous insulin.
No increase in growth rate was observed in the primordial dwarf treated for six months with Wilhelmi HGH, (W HGH), 2 mg. daily for the first fourteen days of each twenty-eight day cycle. Two patients with gonadal dysgenesis treated in a similar manner with 5 mg. of HGH daily showed accelerated linear growth.
All preparations of HGH used were metabolically active, including two preparations from pituitaries from embalmed bodies. All three of the preparations of HGH, including one from pituitaries from embalmed bodies, used for prolonged treatment were capable of stimulating growth rate. A comparison of the potency of the various preparations is not possible due to the limited use of any HGH other than that extracted by Wilhelmi.
During initial metabolic studies the administration of HGH was equally effective when the total dosage was given in one dose daily or in divided doses.
No unequivocal evidence for contamination of the HGH with TSH, ACTH or gonadotropins was obtained.
Ten of twelve hypopituitary dwarfs showed accelerated growth when given 2 mg. of HGH daily for the first fourteen of each twenty-eight days. One patient failed to respond at this dosage level but showed comparable response to a dose of 5 mg. HGH.
Patients receiving more than one eight-month course of injections of HGH, using the same dosage and preparation, exhibited diminished growth response during succeeding courses. This waning effectiveness occurred in one patient despite increases in the dose.
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☆
This work was supported by Grant A-4499 and A-180. Drs. Wright, Brasel, Aceto, Finkelstein, Kenny and Spaulding were supported by Trainee Grant No. 2A-5219, U. S. Public Health Service.
1
From The Department of Pediatrics, Johns Hopkins School of Medicine and Hospital, Baltimore, Maryland.
†
Present address: Illinois State Pediatric Institute, 1640 W. Roosevelt Road, Chicago, Illinois.
‡
Present address: Children's Hospital, 219 Bryant Street, Buffalo, New York
§
Present address: Department of Pediatrics, Montefiore Hospital, Bronx, New York.
∥
Present address: Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
¶
Present address: Department of Pediatrics, University of Kansas Medical Center, Kansas City, Kansas.View full text
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