cosyntropin and Pellagra

An abnormal hyperresponse of GH to intravenous injection of TRH in a 66-year-old female pellagra patient with typical 3'D's was reported. Diagnosis of pellagra was mainly based on her clinical course and manifestations, although serum levels of nicotinic acid and serotonin were within the normal range. Serum vitamin A and B2 levels were low. However, these findings did not exclude the diagnosis. The abnormal GH response to TRH observed in this patient was decreased at 2 months and thoroughly disappeared at 10 months after admission. GH response to arginine showed an exaggerated and sustained response on admission, decreased at 2 months and showed an almost normal pattern at 10 months after admission. TSH and prolactin response to TRH were normal throughout the clinical course. LH and FSH response to LH-RH were exaggerated, suggesting post-menopausal hypogonadism. Cortisol response to ACTH showed slightly sustained reactions at both times of the provocation. Oral glucose tolerance test revealed a slight impairment in this patient. These results suggest that pellagra is one of the disorders which exhibit an abnormal hyperresponse of GH to intravenous administration of TRH.

Topics: Aged; Arginine; Cosyntropin; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Growth Hormone; Humans; Hydrocortisone; Luteinizing Hormone; Pellagra; Pituitary Gland; Prolactin; Thyrotropin; Thyrotropin-Releasing Hormone; Vitamins