Abstract
Endocrine function has been investigated in four anencephalic neonates to determine the influence of absence of cortical and hypothalamic tissue and of hypoplasia of the pituitary. Intravenous glucose administration resulted in higher peak values for blood sugar and more rapid glucose disposal rates than reported in normals. Intravenous insulin tolerance tests on two of the infants failed to evoke elevations in plasma growth hormone, and the infants showed a remarkable resistance to the hypoglycemic effect of insulin. Administration of lysine-vasopressin caused an active growth hormone release. Similarly, there was a large increase in serum thyrotropin after administration of synthetic thyrotropin-releasing hormone. Basal levels of both thyrotropin and growth hormone were low as compared with values reported for normal newborns. Prolactin values obtained on three of the infants were in the normal range. The results strongly suggest that anterior pituitary function mediated by the hypothalamus and its releasing factors is deficient in anencephaly. However, the anterior pituitary can release growth hormone and thyrotropin when stimulated directly and, in the case of thyrotropin release, may function autonomously. The normal prolactin values presumably reflect the absence of the hypothalamic prolactin inhibitory factor.
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Selected References
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- Abrams R. L., Grumbach M. M., Kaplan S. L. The effect of administration of human growth hormone on the plasma growth hormone, cortisol, glucose, and free fatty acid response to insulin: evidence for growth hormone autoregulation in man. J Clin Invest. 1971 Apr;50(4):940–950. doi: 10.1172/JCI106566. [DOI] [PMC free article] [PubMed] [Google Scholar]
- BOWIE M. D., MULLIGAN P. B., SCHWARTZ R. Intravenous glucose tolerance in the normal newborn infant: the effects of a double dose of glucose and insulin. Pediatrics. 1963 Apr;31:590–598. [PubMed] [Google Scholar]
- Bode H. H., Danon M., Weintraub B. D., Maloof F., Crawford J. D. Partial target organ resistance to thyroid hormone. J Clin Invest. 1973 Apr;52(4):776–782. doi: 10.1172/JCI107240. [DOI] [PMC free article] [PubMed] [Google Scholar]
- CORNBLATH M., PARKER M. L., REISNER S. H., FORBES A. E., DAUGHADAY W. H. SECRETION AND METABOLISM OF GROWTH HORMONE IN PREMATURE AND FULL-TERM INFANTS. J Clin Endocrinol Metab. 1965 Feb;25:209–218. doi: 10.1210/jcem-25-2-209. [DOI] [PubMed] [Google Scholar]
- Carter C. O. Genetics of common disorders. Br Med Bull. 1969 Jan;25(1):52–57. doi: 10.1093/oxfordjournals.bmb.a070671. [DOI] [PubMed] [Google Scholar]
- Cassidy C. E., Benotti J., Peno S. Clinical evaluation of the determination of thyroxine iodine. J Clin Endocrinol Metab. 1968 Mar;28(3):420–421. doi: 10.1210/jcem-28-3-420. [DOI] [PubMed] [Google Scholar]
- DRISCOLL S. G., BENIRSCHKE K., CURTIS G. W. Neonatal deaths among infants of diabetic mothers. Postmortem findings in ninety-five infants. Am J Dis Child. 1960 Dec;100:818–835. doi: 10.1001/archpedi.1960.04020040820004. [DOI] [PubMed] [Google Scholar]
- Eddy R. L. Aqueous vasopressin provocative test of anterior pituitary function. J Clin Endocrinol Metab. 1968 Dec;28(12):1836–1839. doi: 10.1210/jcem-28-12-1836. [DOI] [PubMed] [Google Scholar]
- Fekete M., Milner R. D., Soltész G., Assan R., Mestyán J. Plasma glucagon, thyrotropin, growth hormone and insulin response to cold exposure in the human newborn. Acta Paediatr Scand. 1972 Jul;61(4):435–441. doi: 10.1111/j.1651-2227.1972.tb15860.x. [DOI] [PubMed] [Google Scholar]
- Fisher D. A., Odell W. D. Acute release of thyrotropin in the newborn. J Clin Invest. 1969 Sep;48(9):1670–1677. doi: 10.1172/JCI106132. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fisher D. A., Odell W. D., Hobel C. J., Garza R. Thyroid function in the term fetus. Pediatrics. 1969 Oct;44(4):526–535. [PubMed] [Google Scholar]
- Fleischer N., Lorente M., Kirkland J., Kirkland R., Clayton G., Calderon M. Synthetic thyrotropin releasing factor as a test of pituitary thyrotropin reserve. J Clin Endocrinol Metab. 1972 Apr;34(4):617–624. doi: 10.1210/jcem-34-4-617. [DOI] [PubMed] [Google Scholar]
- Frohman L. A. Clinical neuropharmacology of hypothalamic releasing factors. N Engl J Med. 1972 Jun 29;286(26):1391–1397. doi: 10.1056/NEJM197206292862606. [DOI] [PubMed] [Google Scholar]
- Gagliardino J. J., Bailey J. D., Martin J. M. Effect of vasopressin on serum-levels of human growth hormone. Lancet. 1967 Jun 24;1(7504):1357–1358. doi: 10.1016/s0140-6736(67)91764-3. [DOI] [PubMed] [Google Scholar]
- Glick S. M. Hypoglycemic threshold for human growth hormone release. J Clin Endocrinol Metab. 1970 May;30(5):619–623. doi: 10.1210/jcem-30-5-619. [DOI] [PubMed] [Google Scholar]
- Grunt J. A., Reynolds D. W. Insulin, blood sugar, and growth hormone levels in an anencephalic infant before and after intravenous administration of glucose. J Pediatr. 1970 Jan;76(1):112–116. doi: 10.1016/s0022-3476(70)80139-1. [DOI] [PubMed] [Google Scholar]
- HUNTER W. M., GREENWOOD F. C. Preparation of iodine-131 labelled human growth hormone of high specific activity. Nature. 1962 May 5;194:495–496. doi: 10.1038/194495a0. [DOI] [PubMed] [Google Scholar]
- Hagen T. C., Lawrence A. M., Kirsteins L. Autoregulation of growth hormone secretion in normal subjects. Metabolism. 1972 Jul;21(7):603–610. doi: 10.1016/0026-0495(72)90084-4. [DOI] [PubMed] [Google Scholar]
- Himsworth R. L., Carmel P. W., Frantz A. G. The location of the chemoreceptor controlling growth hormone secretion during hypoglycemia in primates. Endocrinology. 1972 Jul;91(1):217–226. doi: 10.1210/endo-91-1-217. [DOI] [PubMed] [Google Scholar]
- Hwang P., Guyda H., Friesen H. A radioimmunoassay for human prolactin. Proc Natl Acad Sci U S A. 1971 Aug;68(8):1902–1906. doi: 10.1073/pnas.68.8.1902. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Isles T. E., Dickson M., Farquhar J. W. Glucose tolerance and plasma insulin in newborn infants of normal and diabetic mothers. Pediatr Res. 1968 May;2(3):198–208. doi: 10.1203/00006450-196805000-00007. [DOI] [PubMed] [Google Scholar]
- Jacobs L. S., Mariz I. K., Daughaday W. H. A mixed heterologous radioimmunoassay for human prolactin. J Clin Endocrinol Metab. 1972 Mar;34(3):484–490. doi: 10.1210/jcem-34-3-484. [DOI] [PubMed] [Google Scholar]
- Kliman B. Recent advances in the double isotope derivative analysis of steroids. Adv Tracer Methodol. 1968;4:227–239. doi: 10.1007/978-1-4684-7532-6_17. [DOI] [PubMed] [Google Scholar]
- Liggins G. C., Kennedy P. C., Holm L. W. Failure of initiation of parturition after electrocoagulation of the pituitary of the fetal lamb. Am J Obstet Gynecol. 1967 Aug 15;98(8):1080–1086. doi: 10.1016/0002-9378(67)90031-2. [DOI] [PubMed] [Google Scholar]
- MacMahon B., Yen S. Unrecognised epidemic of anencephaly and spina bifida. Lancet. 1971 Jan 2;1(7688):31–33. doi: 10.1016/s0140-6736(71)80026-0. [DOI] [PubMed] [Google Scholar]
- Martin L. G., Martul P., Connor T. B., Wiswell J. G. Hypothalamic origin of idiopathic hypopituitarism. Metabolism. 1972 Feb;21(2):143–149. doi: 10.1016/0026-0495(72)90067-4. [DOI] [PubMed] [Google Scholar]
- McCann S. M., Porter J. C. Hypothalamic pituitary stimulating and inhibiting hormones. Physiol Rev. 1969 Apr;49(2):240–284. doi: 10.1152/physrev.1969.49.2.240. [DOI] [PubMed] [Google Scholar]
- NESBITT R. E., Jr Prolongation of pregnancy: a review. Obstet Gynecol Surv. 1955 Jun;10(3):311–362. doi: 10.1097/00006254-195506000-00001. [DOI] [PubMed] [Google Scholar]
- Odell W. D., Wilber J. F., Utiger R. D. Studies of thyrotropin physiology by means of radioimmunoassay. Recent Prog Horm Res. 1967;23:47–85. doi: 10.1016/b978-1-4831-9826-2.50005-2. [DOI] [PubMed] [Google Scholar]
- Patel Y. C., Burger H. G., Hudson B. Radioimmunoassay of serum thyrotropin: sensitivity and specificity. J Clin Endocrinol Metab. 1971 Nov;33(5):768–774. doi: 10.1210/jcem-33-5-768. [DOI] [PubMed] [Google Scholar]
- Soeldner J. S., Slone D. Critical variables in the radioimmunoassay of serum insulin using the double antibody technic. Diabetes. 1965 Dec;14(12):771–779. doi: 10.2337/diab.14.12.771. [DOI] [PubMed] [Google Scholar]
- Sterling K., Brenner M. A. Free thyroxine in human serum: simplified measurement with the aid of magnesium precipitation. J Clin Invest. 1966 Jan;45(1):153–163. doi: 10.1172/JCI105320. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Turkington R. W., Underwood L. E., Van Wyk J. J. Elevated serum prolactin levels after pituitary-stalk section in man. N Engl J Med. 1971 Sep 23;285(13):707–710. doi: 10.1056/NEJM197109232851302. [DOI] [PubMed] [Google Scholar]
- Van Assche F. A. A morphoogical study of the Langerhans' islets of the fetal pancreas in late pregnancy. Biol Neonat. 1968;12(5):331–342. doi: 10.1159/000240119. [DOI] [PubMed] [Google Scholar]
