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Simultaneous assessment of growth hormone and ACTH reserve in children pretreated with diethylstilbestrol.

ABSTRACT Plasma growth hormone (GH) and cortisol responses to insulin-induced hypoglycemia were evaluated in children with growth retardation of various etiologies before and after 3 days of diethylstilbestrol (DES) therapy. It was found that DES not only enhances peak GH responses (mean concentrations were 11.5 ng/ml vs. 19 ng/ml at 60 minutes) but that 4 out of 5 children with absent or blunted GH responses before DES had normal responses after DES. When plasma cortisol concentrations were measured simultaneously, it was found that baseline and 60 minute levels were elevated following DES. However, the 60 minute cortisol response to insulin-hypoglycemia, measured during GH testing, could still be used to assess ACTH reserve. Twentynine children with normal GH responses all achieved 60 minute plasma cortisol values of 40 μg/100 ml or greater, while 5 children with GH deficiency secondary to organic pituitary disease had significantly lower levels. Four patients with idiopathic GH deficiency were tested a...