Abstract. The endocrinological and radiological findings in a 7.5-year-old boy with giantism are reported and compared with an age and sex matched normal tall boy. A 24-h GH profile demonstrated a persistently elevated GH concentration (mean GH concentration: giant 19.3 mU/l; tall boy 5.4 mU/l) with loss of the dominant GH periodicity of 3 h seen in the boy with tall stature and substitution with one of 8 h. These data support the view that giantism and acromegaly are similar diseases occurring prior to and following epiphyseal fusion, respectively.
P.C. Hindmarsh, P.J. Pringle and C. G. D. Brook
C G D BROOK, R STANHOPE, P HINDMARSH and J ADAMS
Puberty encompasses changes in physical appearance and the acquisition of reproductive capability. Many theories have been advanced to explain the control of its onset. The hypothalamo-pituitary-gonadal axis is fully functional in the fetus and newborn infant but a decade follows before secondary sexual characteristics appear. Some form of inhibition has been postulated to account for the delayed onset of puberty but the search for an inhibitor (or stimulator) of pubertal development has been unavailing. It is now clear that gonadal development is continuous from foetal life through childhood, adolescence and the reproductive period. Most information has been acquired in females because of the non-invasive nature of ultrasound examination in assessing ovarian morphology and uterine development. Since both sexes behave in a similar and predictable manner under experimental circumstances, we hypothesize that the mechanism which is clear in females is identical in males.
The celebrated studies of Knobil (1980)
J. W. Honour, C. J. H. Kelnar and C. G. D. Brook
Normal ranges for daily urine steroid excretion rates in childhood are reported for the first time by gas chromatographic analysis using capillary columns and flame ionisation detector. Longitudinal data came from a study over 3 years of 127 normal boys (aged 7.5-15.6 years) studied on 5 occasions and 14 pubertal girls studied over 2 years. Cross-sectional data were collected from 115 hospitalized patients (58 males, 57 females) aged 2.9 to 14 years with normal adrenal function. The excretion rate of cortisol metabolites was constant for body size, whereas androgen metabolite excretion rates rose sharply in childhood to approach adult levels at the end of puberty. The new data will enable better interpretation of pediatric patient data.
F. Darendeliler, P. C. Hindmarsh, M. A. Preece, L. Cox and C. G. D. Brook
We have performed a retrospective analysis of the pubertal parameters of 134 children with isolated GH insufficiency on GH treatment and compared them to the standards of Tanner and to a recent longitudinal study of growth and development in the United Kingdom. The age at onset of puberty (13.0 years in boys, 12.1 years in girls) was found to be significantly delayed (Mann-Whitney p<0.001), but duration of puberty (1.5 years in both sexes) was shortened (Kolgomarov-Smirnov p<0.01). Skeletal maturity at the onset of puberty was not advanced excluding this as a contributory factor. There was no association between dose of GH administered and the pubertal parameters. The results suggest that GH accelerates the pubertal process.