Abstract
Patients suffering from severe cranio-cerebral trauma show alterations of the secretory patterns of thyroid stimulating hormone (TSH) and human growth hormone (HGH) which may be of prognostic significance. We studied 10 patients following severe brain injury and prospectively compared a new synthetic human growth hormone releasing factor (HGHRF) test with the thyrotropin releasing hormone (TRH) test. On admission, all patients had a Glasgow Coma Scale score of 3 or 4. All patients had a low T3 syndrome. In the patients who died the TSH response after stimulation with TRH was also absent. In the patients who survived a significant TSH increase was observed (p<0.05). In comparison to the patients who died those who survived showed a significant (p<0.001) HGH increase after HGHRF stimulation. This test might be useful as an additional tool in establishing early prognosis in patients with severe brain injury.
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Frohman LA (1987) Diseases of the anterior pituitary. In: Felig P Baxter J (eds) Endocrinology and metabolism. McGraw Hill, New York, pp 164–178
Frohman LA, Jansson J (1986) Growth hormone-releasing hormone. Endocr Rev 7:203
Ott L, Young B, McClain C (1987) The metabolic response to brain injury. JPEN 10:488–496
Dieguez C, Page MD, Scanion MF (1988) Growth hormone neuroregulation and its alteration in disease states. Clin Endocrinol 28:109–143
Gottardis M, Hackl JM, Schwarz S (1988) Endocrinological aspects after severe head injury. Intensivbehandlung 13:165–168
Hackl JM (1980) Das Verhalten des Wachstumshormons beim schweren Schädelhirntrauma mit sekundären Hirnstammschäden. Infusionstherapie 5:237–247
Sassolas G, Biot-Laporte S, Cohen R, Chatelain P, Boissel JP, Ferry S, Chayvialle JA, Dupin P, Garray P, Claustrat B, Girand P, Borson F, Trouillas J, Loras B (1986) Clinical studies with human growth hormone releasing factor in normal adults and patients. Peptides 7:281–286
Takano K, Schizume K, Imura H, Irie M, Kumahara Y, Shimuzu N (1987) Plasma growth hormone (GH) response to GH-releasing factor (SM-8134) in children of short stature and patients with GH deficiency. Endocrinol Jpn 34:117–128
Carr D, McLeod DT, Parry G, Thomes HM (1988) Fine adjustment of thyroxine replacement dosage: comparison of thyrotropin releasing hormone test using a sensitive thyrotropin assay with measurement of free thyroid hormones and clinical assessment. Clin Endocrinol 28:325–329
Wehmann RE, Gregeman RI, Bums W, Saral R, Santos GW (1985) Suppression of thyrotropin in the low-thyroxine state of severe non thyroidal illness. N Engl J Med 9:546–552
Köhrle J (1982) Physiologische und biochemische Grundlagen des extrathyreoidalen Stoffwechsels von L-Thyroxin und anderen Jodthyroninen. Aktuel Endokrinol Stoffwechsel 3:2–12
Hoeffler JP, Frawley LS (1987) Hypothalamic factors differentially affect the proportions of the cells that secrete growth hormone or prolactin. J Endocrinol 118:791–796
Renaud LP, Martin JB, Brazeau P (1975) Depressant action of TRH, LH-RH and somatostatin on activity of central neurones. Nature 255:233–239
Siler TM, Yen SSC, Vale W, Guillemin R (1974) Inhibition by somatostatin on the release of TSH induced in man by thyrotropin releasing factor. J Clin Endocrinol Metab 38:742–746
Philips LS (1986) Nutrition, somatomedins and the brain. Metabolism 35:78–87
Hesch RD (1982) Schilddrüsenerkrankungen und thyroxinbindendes Globulin beim Schwerkranken. Aktuel Endokrinol Stoffwechsel 3:24–29
Oppenheimer JH, Schartz HL, Mariash CN, Kaiser FE (1962) Evidence for a factor in the sera of patients with nonthyroidal disease which inhibits iodothyronine binding by solid matrices, serum proteins, and rat hepatocytes. J Clin Endocrinol Metab 54:757–763
Westmark K, Alm J, Skottner A, Karlsson A (1988) Effects of treatment for hyper- and hypothyroidism on serum IGF-1 and urinary epidermal growth factor concentrations. Acta Endocrinol 118:415–419
Chiolero R, Lemachand T, Schutz Y, De Tribolet N, Felber JP, Freeman J Jequier E (1988) Plasma pituitary hormone levels in severe trauma with or without head injury. J Trauma 28:1368–1374
Chiolero R, Lemachand T, Schutz Y, De Tribolet N, Bayer M, Freeman J (1988) Thyroid function in severely traumatized patients with or without head injury. Acta Endocrinol 117:80–86
Matsuura H, Nakazawa S, Wakabayashi I (1985) Thyrotropin releasing hormone provocative release of prolactin and thyrotropin in acute head injury. Neurosurgery 16:791–795
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Gottardis, M., Nigitsch, C., Schmutzhard, E. et al. The secretion of human growth hormone stimulated by human growth hormone releasing factor following severe cranio-cerebral trauma. Intensive Care Med 16, 163–166 (1990). https://doi.org/10.1007/BF01724795
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DOI: https://doi.org/10.1007/BF01724795