Table 1.

Combined pituitary and dynamic function tests at diagnosis

	Serum	Patient 1					Patient 2		Patient 3
		0 min	20 min	60 min	120 min	Impression	0 min	30 min	0 min	30 min
Anterior pituitary
GNRH stimulation test
	FSH	1.4	1.5	2.0	–		3.9	–	1.0	–
	LH	0.1	0.3	0.6	–		0.7	–	0.4	–
	Oestradiol	a	–	–	–		18	–	–	–
	SHBG	123.5	–	–	–		–	–	–	–
	Testosterone	–	–	–	–		–	–	0.8	–
						With Tanner stage 3 breast development, this GNRH test suggests pubertal arrest
GH stimulation test
	GH	0.4	0.2	0.4	0.4		–	–	0.2	–
	IGF1	77	–	–	–		48	–	96	–
						Low IGF1 along with peak GH <5.5 suggests growth hormone deficiency
Synacthen test
	Cortisol	158	282	360	–		b 55	b 229	68 (random)
	ACTH	10.5 (0900 h)	–	–	–		b 5.8 (0000 0.25 h)	–	–	–
						Adrenal insufficiency with a relatively normal ACTH
TRH test
	TSH	2.65	8.68	13.15	–		1.8	–	0.36	–
	FT4	8.3	–	–	–		8.7	–	9.4	–
	FT3	3.73	–	–	–		2.7	–	–	–
						Hypothalamic response to TRH suggests central hypothyrodism
	Prolactin	1034	–	–	–	Raised	2207	–	424	–
Posterior pituitary
	Plasma osmolality	300	–	–	–		b 296	–	300	–
	Urine osmolality	301	–	–	–		b 99	–	349	–
	Sodium	145	–	–	–	Normal c	b 144	–	135	–
Others c
	Plasma HbA1c	–	–	–	–		109	–	–	–
	Plasma random glucose	–	–	–	–		9.5	–	–	–
	Bone age	delay by 2 years

^aUnrecordable.

^bPost-surgery.

^cPatient 2 had diabetes insipidus.