The 24-hour growth hormone secretion in a boy with giantism

Aseptic meningitis caused by human parvovirus B19

Reports on aseptic meningitis caused by human parvovirus B19 are extremely rare. A case of aseptic meningitis is described in which human parvovirus B19 DNA was detected in the acute phase in cerebrospinal fluid by the polymerase chain reaction.

Intermittent versus continuous administration of growth hormone treatment

Growth hormone treatment given by daily injection was compared with growth hormone given for three weeks of every four. All children had received recombinant human growth hormone for two years before randomisation. Growth velocity decreased in both groups in years one and two of the study but the effect was significantly greater in the group receiving intermittent growth hormone.

Pituitary gigantism

A case of pituitary gigantism resulting from a pituitary adenoma which secreted growth hormone is described. The patient was successfully treated by surgery, which led to the normalisation of endogenous growth hormone secretion. An acceptable final height was achieved with high dose intramuscular testosterone treatment.

A distribution method for analysing the baseline of pulsatile endocrine signals as exemplified by 24-hour growth hormone profiles

OBJECTIVE

To develop a method for quantifying the distribution of concentrations present in hormone profiles, which would allow an observer-unbiased estimate of the time concentration attribute and to make an assessment of the baseline.

DESIGN

The log-transformed concentrations (regardless of their temporal attribute) are sorted and allocated to class intervals. The number of observations in each interval are then determined and expressed as a percentage of the total number of samples drawn in the study period. The data may be displayed as a frequency distribution or as a cumulative distribution. Cumulative distributions may be plotted as sigmoidal ogives or can be transformed into discrete probabilities (linear probits), which are then linear, and amenable to regression analysis. Probability analysis gives estimates of the mean (the value below which 50% of the observed concentrations lie, which we term 'OC50'). 'Baseline' can be defined in terms of percentage occupancy--the 'Observed Concentration for 5%' (which we term 'OC5') which is the threshold at or below which the hormone concentrations are measured 5% of the time.

PATIENTS

We report the use of applying this method to 24-hour growth hormone (GH) profiles from 63 children, 26 adults and one giant.

RESULTS

We demonstrate that GH effects (growth or gigantism) in these groups are more related to the baseline OC5 concentration than peak concentration (OC5 +/- 95% confidence limits: adults 0.05 +/- 0.04, peak-height-velocity pubertal 0.39 +/- 0.22, giant 8.9 mU/l).

CONCLUSIONS

Pulsatile hormone profiles can be analysed using this method in order to assess baseline and other concentration domains.