Effect of aldosterone on renal tubular sodium resorption in congenital virilizing adrenal hyperplasia

A third group about which we have a question is one of children with malabsorption syndrome and failure of growth. We have 2 such children who fail to show growth hormone. It is interesting that one of our patients, with short stature, and no measurable growth hormone, on human growth hormone administration, despite increased nitrogen retention and increased hydroxyprollne excretion, still showed no increase in stature. DR. KAPLAN. We have not tested any patients with obesity. Since we have only tested one patient with hypothyroidism before and after treatment, I do not think we can comment beyond our own experience. I think that it is quite possible that the posttreatment response may not be observed immediately after institution of thyroid therapy. We have measured growth hormone in only 2 patients who had the malabsorption syndrome and in 2 patients who had severe malnutrition secondary to anorexia nervosa. In 3 of the 4 patients, the serum growth hormone levels were markedly elevated. In the fourth patient, the serum growth hormone concentration was within the normal range. Some of the differences in results obtained in our laboratory may be the result of methodology since you use the hemagglutination inhibition method as modified by Dominguez and Pearson for measuring human growth hormone and we use a radioimmunoassay procedure. DR. WILLIAM A. COGHRANE, The Children's Hospital, University Ave., Halifax, Nova Scotia, Canada. Dr. Kaplan, I have two questions. One: Could you tell me if you had observed any change in serum growth hormone levels in normal children when the insulin was administered over 2 or 3 days? In other words, is there any suggestion that there is a reduction in terms of the release of growth hormone in a normal individual when they are retested over a 2 or 3 day period consecutively ? Second: Have you done any determinations in patients with idiopathic hypoglycemia and do you note any hyper rather than hypo response ? DR. KAPLAN. Three patients were tested on 2 consecutive days with no demonstrable evidence of differences in their serum growth hormone response. We have not completed our studies of the patients with hypoglycemia.