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Morris AH, Joyce JL, Reiter EO. Increased insulin-like growth factor I binding to red blood cells of normal prepubertal children. Pediatr Res 1989; 25:409-13. [PMID: 2726318 DOI: 10.1203/00006450-198904000-00021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Young children are growing at a time when circulating levels of IGF-I measured by RIA are generally less than or equal to values in nongrowing adults. 125I-Thr59-IGF-I binding to receptors on conveniently available red blood cells was studied in 33 normal adults (nine males, 24 females) and 13 normal prepubertal children aged 3-10 y (10 boys, three girls; all Tanner stage 1). Red blood cell specific binding of 125I-Thr59-IGF-I was determined by displacement of labeled Thr59-IGF-I by unlabeled Thr59-IGF-I or insulin in a dose-dependent manner. Mean (+/- SEM) 125I-Thr59-IGF-I specific binding was significantly higher (p = 0.01) in prepubertal children than in adults (13.9 +/- 0.7% versus 11.6 +/- 0.5%/3 x 10(9) cells/mL). Specific binding did not differ between adult males and females. There was no significant correlation between specific binding and reticulocyte count. Scatchard analysis demonstrated a linear plot. Increased binding to red blood cells in the prepubertal children appeared to be due to an increase in receptor affinity (Ka = 4.97 +/- 0.42 x 10(8) M-1 versus 3.70 +/- 0.41 x 10(8) M-1; children versus adults; p = 0.03). Mean receptor concentrations were not different in children and adults (64.4 +/- 8.5 versus 58.0 +/- 5.6 binding sites/cell). There was a significant positive correlation between 125I-Thr59-IGF-I specific binding and affinity (p = 0.007, r = 0.39). We speculate that the greater specific binding of labeled Thr59-IGF-I to red blood cells in prepubertal children may provide a mechanism for enhanced cellular responsiveness to relatively low levels of circulating IGF-I.
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Albini CH, Reiter EO, Mills BJ, MacGillivray MH. Diagnostic value of the growth hormone-releasing factor stimulation test. Clin Pharmacol Ther 1988; 43:696-700. [PMID: 3132344 DOI: 10.1038/clpt.1988.98] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Growth hormone (GH) responses to growth hormone-releasing factor (GRF) were evaluated in 55 children with growth failure. The study groups consisted of group 1, severe GH deficiency; group 2, partial GH deficiency; group 3, patients with prior cranial radiation for nonpituitary brain tumors; and group 4, children with idiopathic growth failure. Children in group 1 were unresponsive to GRF (mean GH peak +/- SEM, 1.6 +/- 0.5 ng/ml). Higher GH responses to GRF were observed in both groups 2 (17.2 +/- 4.1 ng/ml) and 3 (10.4 +/- 2.8 ng/ml). The highest GH responses to GRF were observed in group 4 (35.9 +/- 4.3 ng/ml). ANOVA revealed a significant difference between groups (F = 12.9; df = 3; p less than 0.01), and further analysis by the Scheffe and Student-Newman-Keuls tests revealed that group 4 was significantly higher than groups 1, 2, or 3 (p less than 0.05). These data suggest that GRF unresponsiveness is a reliable predictor of severe GH deficiency. In patients with partial GH deficiency or idiopathic growth failure, the GRF gives semiquantitative information about somatotrope responsivity to exogenous stimulation.
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Reiter EO, Morris AH, MacGillivray MH, Weber D. Variable estimates of serum growth hormone concentrations by different radioassay systems. J Clin Endocrinol Metab 1988; 66:68-71. [PMID: 3335610 DOI: 10.1210/jcem-66-1-68] [Citation(s) in RCA: 73] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Many different assays are being used to measure serum GH concentrations in children with disorders of growth. We assessed four readily available methods to determine the comparability of the immunopotency estimates: standard double antibody RIA with pituitary standards from the National Hormone and Pituitary Program (assay 1) and from a commercial source (assay 2), a double antibody RIA with serum standards (assay 4), and a commercial immunoradiometric assay (assay 3). There was a high degree of relative correlation between assays (r = 0.95-0.98), but absolute potency estimates differed. Assays 1 and 2 were almost identical. Assay 3 yielded serum GH levels about 65% those of assay 1 or 2 and 80% those of assay 4. Assay 4 gave intermediate values between the low readings in assay 3 and higher values in assay 1 and 2. We conclude that substantial variation occurs in potency estimates in different GH assays. Such differences can affect the interpretation of many GH provocative and sampling studies.
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Morris AH, Reiter EO. Growth hormone: diagnostic and therapeutic dilemmas. SEMINARS IN ADOLESCENT MEDICINE 1987; 3:283-91. [PMID: 3324248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Reiter EO. Neuroendocrine control processes. Pubertal onset and progression. JOURNAL OF ADOLESCENT HEALTH CARE : OFFICIAL PUBLICATION OF THE SOCIETY FOR ADOLESCENT MEDICINE 1987; 8:479-91. [PMID: 3319980 DOI: 10.1016/0197-0070(87)90049-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This discussion has outlined current concepts in neuroendocrinologic control of pubertal onset and progression. Central nervous system regulation of the arcuate nucleus (ventromedial hypothalamus) pulse generator that subsequently controls pituitary gonadotropin synthesis and secretion has been highlighted. Significant investigative issues that deserve assessment in the next several years include the following: 1. Systematic neuropharmacologic, electrophysiologic, and anatomic assessment of the hypothalamic arcuate nucleus. These assessments would include the use of recombinant DNA technology to probe cellular regulation of GnRH production. 2. Physiologically oriented examination of hypothalamic GnRH synthesis and secretion, along with function in the remaining reproductive endocrine system, during situations of nutritional impairment and excessive energy utilization and psychologic stress. 3. Further assessment of the neurophysiologic inhibition of GnRH production during childhood and the late prepubertal reactivation of the arcuate nucleus pulse generator. Roles of opioids, dopamine, other neurotransmitters, and metabolic signals remain to be clarified. 4. Exploration of regulators of hypothalamic, pituitary, and gonadal function when pulsatile GnRH administration has replaced the usual hypothalamic mechanisms. Pituitary-gonadal interactions may be independently assessed. 5. Assessment of pubertal growth, endocrine function, and neuropharmacologic control mechanisms in circumstances of chemical removal of pituitary gonadotrope function by GnRH agonists or antagonists. 6. Concordance and discordance of potency estimates of gonadotropins made by bioassay and immunoassay. The biologic basis for qualitative changes in bioassayable levels of LH and FSH, often related to carbohydrate content of the glycoprotein, may help to explain changes of gonadal function during the pubertal process. The potential for significant molecular heterogeneity of the gonadotropins is recognized and suggests substantial posttranslational changes of LH and FSH. 7. A cogent delineation of the hormonal, nutritional, and energy regulators of the pubertal growth spurt, though not discussed in this manuscript, remains to be accomplished. The relationship between pituitary gonadotropins and growth hormone, sex steroids, and the various peptide growth factors, especially the relationship between the growth factors and intragonadal steroidogenesis and germ-cell production, remain to be resolved. The importance of local production and action of peptide-growth factors in diverse tissues, skeletal and other, is being increasingly recognized.(ABSTRACT TRUNCATED AT 400 WORDS)
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Rowland TW, Morris AH, Kelleher JF, Haag BL, Reiter EO. Serum testosterone response to training in adolescent runners. AMERICAN JOURNAL OF DISEASES OF CHILDREN (1960) 1987; 141:881-3. [PMID: 3631020 DOI: 10.1001/archpedi.1987.04460080067028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Reiter EO, Biggs DE, Veldhuis JD, Beitins IZ. Pulsatile release of bioactive luteinizing hormone in prepubertal girls: discordance with immunoreactive luteinizing hormone pulses. Pediatr Res 1987; 21:409-13. [PMID: 2437520 DOI: 10.1203/00006450-198704000-00018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
An assessment of pulsatile secretion of luteinizing hormone (LH), measured by both immunoassay (I-LH) and rat interstitial cell testosterone production bioassay (B-LH), as well as of follicle-stimulating hormone and glycoprotein hormone alpha-subunit was carried out in seven normal prepubertal and six normal premenarcheal pubertal girls. Samples were obtained at 20-min intervals for a 6-h period. The hormone secretion profiles were analyzed by several computerized methods yielding pulse frequency and amplitude, interpulse basal levels, and percentage increments, with bio/immuno ratios calculated for peak and basal concentrations. In these prepubertal girls, mean B-LH levels were 12% of I-LH, with B/I ratio of 0.13; 30% of samples were below assay sensitivity (0.10 mIU/ml) for B-LH, but all I-LH (1.25 mIU/ml) were detectable. In the pubertal group, B-LH levels were 30% of I-LH, with mean B/I ratio of 0.24 and undetectable B-LH in 29% of samples. Pulsatile secretion in prepubertal girls was found in five of seven (1/150 min) for B-LH and six of seven (1/212 min) for I-LH; only two of six pubertal girls had detectable pulses. Discordance of B- and I-LH pulses were frequent, with 56% of B-LH pulses lacking an I-LH pulse and 47% of I-LH pulses not having a B-LH pulse. These data demonstrate that both B- and I-LH are secreted episodically in prepubertal girls; I-LH-like material is present in higher concentrations than B-LH in these girls; and substantial discordance of B- and I-LH pulses exist.(ABSTRACT TRUNCATED AT 250 WORDS)
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Morris AH, Reiter EO. Corticotropin deficiency in Russell-Silver syndrome. AMERICAN JOURNAL OF DISEASES OF CHILDREN (1960) 1986; 140:856-7. [PMID: 3017095 DOI: 10.1001/archpedi.1986.02140230026017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Sheehan PQ, Rowland TW, Shah BL, McGravey VJ, Reiter EO. Maternal diabetic control and hypertrophic cardiomyopathy in infants of diabetic mothers. Clin Pediatr (Phila) 1986; 25:266-71. [PMID: 3698447 DOI: 10.1177/000992288602500507] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Hypertrophic cardiomyopathy has been well documented in infants of diabetic mothers (IDMs). If this asymmetric septal enlargement is an anabolic result of fetal hyperinsulinemia triggered by maternal hyperglycemia during the third trimester, maternal glycosylated hemoglobin (HbA1) levels, an indicator of glycemic control, should then correlate positively at delivery with newborn ventricular septal thickness. In this study of 20 infants of well-controlled diabetic mothers, no relationship was observed between echocardiographic evidence of hypertrophic cardiomyopathy and maternal HbA1 levels. Seven babies (35%) exhibited exaggerated septal thickening, but none had cardiac-specific symptoms. Although 60 percent of the IDMs were large for gestational age and 45 percent demonstrated neonatal hypoglycemia, neither of these complications correlated with maternal HbA1. In this group of babies of well-controlled diabetic women, echocardiographic indicators of cardiomyopathy were common, but clinical evidence of cardiac embarrassment was not observed. Moreover, these data do not support third trimester maternal hyperglycemia as instrumental in the etiology of cardiomyopathy and other complications of IDMs.
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Rowland TW, Swadba LA, Biggs DE, Burke EJ, Reiter EO. Glycemic control with physical training in insulin-dependent diabetes mellitus. AMERICAN JOURNAL OF DISEASES OF CHILDREN (1960) 1985; 139:307-10. [PMID: 3883748 DOI: 10.1001/archpedi.1985.02140050101035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Reiter EO, Brugman SM, Pike JW, Pitt M, Dokoh S, Haussler MR, Gerstle RS, Taussig LM. Vitamin D metabolites in adolescents and young adults with cystic fibrosis: effects of sun and season. J Pediatr 1985; 106:21-6. [PMID: 3871230 DOI: 10.1016/s0022-3476(85)80458-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
To assess mineral metabolism in patients with cystic fibrosis and to study the effects of season and sunlight exposure on generation of vitamin D metabolites, we quantified serum levels of calcidiol and calcitriol, other measures of bone metabolism, and radiographic bone mass in 20 adolescents and young adults with CF and 20 age-matched normal volunteers. Levels of calcidiol were lower in patients with CF than in controls and lower in Massachusetts than in Arizona in both study groups. Controls in Arizona had higher (P less than 0.05) levels of calcitriol than in Massachusetts throughout the year. All control subjects in both states had higher levels of calcitriol than did patients with CF. Patients in Massachusetts had significantly lower levels of calcitriol in winter than in summer. Summer levels of calcitriol in CF were significantly higher in Massachusetts than in Arizona; during winter, lower levels were found in Massachusetts than in Arizona. Mean bone density in patients with CF was 88% and 89% of normal American standards in Massachusetts and Arizona, respectively. These data indicate a seasonal, sunlight-related influence on levels of vitamin D metabolites in patients with CF receiving approximately 1000 IU vitamin D per day. Older patients with CF with progressively diminishing sunlight exposure may be at increased risk for development of osteopenia. The detected radiographic abnormalities of bone mineralization may also be related to malabsorptive deficiencies of calcium and phosphorus.
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Reiter EO, Brown RS, Longcope C, Beitins IZ. Male-limited familial precocious puberty in three generations. Apparent Leydig-cell autonomy and elevated glycoprotein hormone alpha subunit. N Engl J Med 1984; 311:515-9. [PMID: 6205273 DOI: 10.1056/nejm198408233110807] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Reiter EO. The somatomedins: involvement in growth processes and disorders. COMPREHENSIVE THERAPY 1983; 9:45-55. [PMID: 6340938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Root AW, Duckett GE, Sweetland M, Livingston C, Reiter EO. Human growth hormone blunts Na2EDTA-induced hypocalcaemia in hyposomatotrophic children. ACTA ENDOCRINOLOGICA 1983; 102:11-5. [PMID: 6401886 DOI: 10.1530/acta.0.1020011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
An infusion of disodium ethylenediamine tetraacetate (Na2EDTA) (0.13 mmol/kg for 2 h) was administered to 10 hyposomatotrophic children prior to and after 6 and 12 months of treatment with human growth hormone (hGH). Total and ionized calcium and immunoreactive parathyroid hormone (iPTH) concentrations were determined. Mean basal total and ionized calcium concentrations did not change during the year of treatment with hGH. The nadir concentrations of total and ionized calcium increased progressively during hGH administration and after 12 months were significantly increased over pre-treatment values (total calcium: pretreatment 1.85 +/- 0.32 (SD) mmol/l, +12 months 2.10 +/- 0.15, P less than 0.01; ionized calcium: pre-treatment 0.55 +/- 0.31 mmol/l, +12 months 0.78 +/- 0.14, P less than 0.05). The mean basal concentration of iPTH increased slightly after 12 months of hGH administration (pre-treatment 72 +/- 18 pg/ml, +12 months 106 +/- 71, P less than 0.05), but Na2EDTA-evoked secretion of iPTH was not significant altered by hGH.
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Rowland TW, Zori RT, Lafleur WR, Reiter EO. Malnutrition and hypernatremic dehydration in breast-fed infants. JAMA 1982; 247:1016-7. [PMID: 7057575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Despite the well-recognized advantages of breast-feeding to both mother and child, malnutrition of breast-fed infants can occur. We report two cases of breast-fed infants with cachexia, hypernatremia, and, in the one case in which it was measured, an elevated level of breast-milk sodium. These cases, along with several reported previously, emphasize the need for proper education and close and early follow-up of the nursing mother and infant, especially since a lack of parental awareness can be part of this syndrome.
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Reiter EO, Stern RC, Root AW. The reproductive endocrine system in cystic fibrosis: 2. Changes in gonadotrophins and sex steroids following LHRH. Clin Endocrinol (Oxf) 1982; 16:127-37. [PMID: 6802528 DOI: 10.1111/j.1365-2265.1982.tb03156.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Hypothalamic-pituitary-gonadal function was assessed in forty-seven patients with cystic fibrosis (CF) by the 3-hr infusion of 100 microgram of synthetic gonadotrophin-releasing factor. LHRH and the results compared with a group of children being evaluated for short stature and delayed puberty ('controls'). Levels of gonadotrophins and sex steroids were measured prior to and during the infusion. In prepubertal boys, LH and FSH release evoked by LHRH was significantly greater (P less than 0.001) in 'control' subjects than in CF patients. In pubertal boys, LH and FSH release was also greater in 'controls' than in CF, though to a lesser degree (P less than 0.05). In pubertal girls, responses to LHRH were comparable for LH and slightly greater (P less than 0.05) in 'controls' for FSH. In the earliest pubertal groups of both sexes (male-Tanner genitalia stage 2; females-Tanner breast stage 2), LH secretion was similar in patients with CF and 'control' subjects. Significant increments of testosterone and oestradiol in pubertal CF patients do not occur until 6 h after the LHRH infusion begins, in contrast to a rise at 3 h in 'control' subjects. These data suggest that prepubertal boys with CF, who are the most impaired in height, weight and skeletal maturation, also have measurable abnormalities of LHRH-releasable gonadotrophin secretion. Despite continued impaired weight growth, pubertal patients do attain essentially normal gonadotrophin secretory responses to LHRH administration and are similar to subjects with constitutional delayed adolescent development in reproductive endocrine physiology.
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Reiter EO, Beitins IZ, Ostrea T, Gutai JP. Bioassayable luteinizing hormone during childhood and adolescence and in patients with delayed pubertal development. J Clin Endocrinol Metab 1982; 54:155-61. [PMID: 7054212 DOI: 10.1210/jcem-54-1-155] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Reiter EO, Lovinger RD. The use of a commercially available somatomedin-C radioimmunoassay in patients with disorders of growth. J Pediatr 1981; 99:720-4. [PMID: 7197712 DOI: 10.1016/s0022-3476(81)80391-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Somatomedin-C concentrations were measured by a newly available commercial radioimmunoassay in plasma samples from 41 children undergoing clinical evaluation of hypothalamic-pituitary function because of varied disorders of growth. Sequential Sm-C levels were stable; the coefficient of variation remained below 10% over a three-hour period. The Sm-C values of 27% of the children were discordant with the GH responses; of 25 patients with normal provoked-GH levels, seven had low Sm-C values, whereas four of 16 patients with inadequate GH responses had normal Sm-C concentrations. All of the discordant data occurred in 31 patients with diminished linear growth velocity. More patients with decreased growth velocity had diminished Sm-C levels than did short children with normal linear growth velocity. These data suggest that many variables, in addition to adequacy of GH production and plasma Sm-C levels, may affect net Sm-C activity. This possibly reduces the usefulness of the Sm-C radioimmunoassay as a single screening test for abnormalities of GH secretion.
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Abstract
Evaluation of a child with goiter includes historical review, physical examination, and measurement of serum concentrations of PBI, T4 and T3RU, TSH, and titers of antithyroglobulin and antithyroid microsomal antibodies. If there are no indications for more intensive evaluation such as history of cervical irradiation, a palpable abnormality of the thyroid gland or unusual laboratory findings (e.g., a significant PBI-thyroxine iodine discrepancy in the absence of a positive antithyroid antibody titer), a trial of TSH-suppressive therapy with thyroxine is undertake, even if the cause of thyromegaly has not been identified. If thyroid size diminishes in the ensuing six to 12 months, treatment is maintained for approximately two years and then discontinued. If the goiter recurs, or if there is impaired thyroid function, treatment is resumed. Periodically, antithyroid antibody titers and indices of thyroid function are determined. If the goiter does not diminish after a reasonable trial of suppressive therapy with adequate amounts of thyroxine (i.e., those quantities which will inhibit TRH-induced secretion of TSH), subtotal thyroidectomy is recommended to be certain that an underlying neoplasm has not been overlooked. A biopsy of the thyroid is not performed routinely in such children prior to operative therapy. Almost invariably, examination of the surgical specimen reveals CLT. Postoperatively, suppressive doses of thyroxine are maintained indefinitely. Inasmuch as thyroxine suppression of TSH secretion is essential in the management of patients with thyroid neoplasms, a limited medical trial, as described, does not place the patient at undue risk.
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Rettig K, Duckett GE, Sweetland M, Reiter EO, Root AW. Urinary excretion of immunoreactive luteinizing hormone-releasing hormone-like material in children correlation with pubertal development. J Clin Endocrinol Metab 1981; 52:1150-5. [PMID: 7014595 DOI: 10.1210/jcem-52-6-1150] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Immunoreactive LRH (iLRH)-like material has been measured in extracts of urine from normal children and adolescents, adult men and women, and postmenopausal women. The urinary excretion of iLRH-like material was significantly greater in pubertal than in prepubertal subjects and in boys than girls at both stages of sexual maturation [prepubertal males, 3.26 +/- 0.49 ng/24 h (SE; n = 24); pubertal males, 5.94 +/- 1.36 (n = 12); prepubertal females, 1.14 +/- 0.21 (n = 19); pubertal females, 2.85 +/- 0.56 (n = 13)]. In adult males (n = 5) the urinary excretion of iLRH-like material was 7.8 +/- 1.3 ng/24 h, and in adult women in the follicular phase of the menstrual cycle (n = 8) it was 2.9 +/- 0.3. In five postmenopausal women the urinary iLRH-like content was 7.32 +/- 0.92 ng/24 h (P less than 0.01 relative to normal pubertal and adult women). In children the 24-h urinary excretion of iLRH-like material was positively correlated with chronological and bone ages, Tanner stage of genital (male) and breast (female) development, and the urinary excretion of LH and FSH in males. It did not correlate with the urinary excretion of either LH or FSH in females. Carboxymethylcellulose chromatography of extracts of urine from pubertal boys and girls, adult men and women, and postmenopausal women suggested that the iLRH-like material may be the 2-10 fragment of LRH rather than the intact decapeptide.
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Reiter EO, Duckett GE, Root AW. Further studies of the effects of intravenous infusion or intramuscular injection of gonadotropin-releasing hormone during childhood and adolescence. JOURNAL OF ADOLESCENT HEALTH CARE : OFFICIAL PUBLICATION OF THE SOCIETY FOR ADOLESCENT MEDICINE 1981; 1:275-81. [PMID: 6800992 DOI: 10.1016/s0197-0070(81)80007-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
To provide data on the readily releasable pools of pituitary gonadotropins and to compare routes of administration, gonadotropin-releasing hormone (Gn-RH, 100 micrograms) was administered to 135 endocrinologically normal children and adolescents by continuous intravenous 3-hour infusion or by acute intramuscular injection. The Gn-RH infusion resulted in a significant four- and sevenfold increase in serum luteinizing hormone (LH) values in prepubertal subjects and pubertal males, respectively. A 14-fold increment, biphasic in appearance, occurred in pubertal females. Gn-RH-induced serum follicle-stimulating hormone (FSH) increases were greater in females than in males. Following intramuscular injection of Gn-RH, a monophasic increment of serum LH and FSH occurred. LH rises were greater in pubertal than in prepubertal children and greater in females than in males. FSH increments were greater in females than in males, prepubertal being slightly greater than pubertal. Urinary gonadotropin excretion mirrored the changes in the serum samples. These results in the largest reported group of normal children generally confirm those of previous reports except for the greater Gn-RH-evoked releasable LH in pubertal females than in males.
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Reiter EO, Stern RC, Root AW. The reproductive endocrine system in cystic fibrosis. I. Basal gonadotropin and sex steroid levels. AMERICAN JOURNAL OF DISEASES OF CHILDREN (1960) 1981; 135:422-6. [PMID: 7234767 DOI: 10.1001/archpedi.1981.02130290020009] [Citation(s) in RCA: 59] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Serum gonadotropin and sex steroid levels were measured in 106 patients with cystic fibrosis (CF), 46 males and 60 females, aged 8 to 24 years. The finding of delayed pubertal increments of serum gonadotropin and sex steroid levels in CF patients suggests late maturation of the reproductive endocrine system. Although pubertal changes in reproductive endocrine hormones in patients with CF appear to be temporally delayed, generally appropriate levels of these hormones are finally attained in most patients by the late teenage years. Delayed maturation of the reproductive endocrine system probably is secondary to hypothalamic-pituitary dysfunction, the result of chronic inanition.
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Schedewie HK, Reiter EO, Beitins IZ, Seyed S, Wooten VD, Jimenez JF, Aiman EJ, DeVane GW, Redman JF, Elders MJ. Testicular leydig cell hyperplasia as a cause of familial sexual precocity. J Clin Endocrinol Metab 1981; 52:271-8. [PMID: 6780588 DOI: 10.1210/jcem-52-2-271] [Citation(s) in RCA: 91] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Testicular Leydig cell hyperplasia was observed in two brothers presenting with progressive sexual precocity at 2 yr of age. Virilization was shown to result from increased secretion rather than decreased clearance of gonadal testosterone. Testosterone hypersecretion appeared to be gonadotropin independent, as basal and gonadotropin-releasing hormone-induced serum LH concentrations were low by both RIA and bioassay. Adrenal steroidogenesis was demonstrated to be normal by ACTH stimulation, dexamethasone suppression, and split adrenal venous function tests. Testicular histology revealed immature reproductive structures in the 2 yr old, but advanced spermatogenesis in the 3 yr-old brother. The etiology of both Leydig cell hyperplasia and reproductive testicular maturation in the absence of significant gonadotropin secretion remains to be established.
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Reiter EO, Duckett GE, Root AW. Responses to constant infusion of LH-RH in girls with primary hypogonadism. Obstet Gynecol 1980; 56:339-43. [PMID: 6448363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
To further assess quantitative pituitary gonadotropin release in patients with primary hypogonadism, a 3-hour constant infusion of the synthetic gonadotropin-releasing hormone, LH-RH, was administered to 12 functionally agonadal girls (11 with Turner syndrome and 1 who had been overiectomized), aged 9.5 to 19.42 years. Gonadotropin and sex steroid responses were determined before and during the infusion and contrasted to those in normal pubertal females. in girls with skeletal age under 11 years, mean control LH increased (P < .001) from 2.2 +/- 0.3 (mean +/- SEM) mIU/ml to 21.3 +/- 7.3 during LH-RH infusion, while luteinizing hormone (LH) rose (P < .001) from 89.2 +/- 24.6 to 276.5 +/- 42.6 girls with skeletal age over 11 years. This age-related augmentation is an exaggeration of data in normal girls and occcurs despite minimal gonadal secretion of sex steroids. A similar age-related discrepancy was not seen in follicle-stimulating hormone (FSH) secretion evoked by LH-RH; all girls had FSH increments into the castrate range with a rise from mean control levels of 78.6 +/- 6.7 to 133.9 +/- 8.3. These data demonstrate an age-related increase in LH-RH-evoked LH secretion, but not of FSH, in children and adolescents with primary hypogonadism.
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