Schulte H M, Benker G, Windeck R, Olbricht T, Reinwein D
J Clin Endocrinol Metab. 1985 Sep;61(3):585-7. doi: 10.1210/jcem-61-3-585.
Growth hormone releasing hormone (GHRH) has recently been isolated and sequenced from pancreatic tumors secreting GHRH. Patients with untreated acromegaly due to a pituitary tumor respond to exogenous administration of GHRH with a further rise of their elevated basal growth hormone (GH) levels. For the first time, we report the effects of exogenously administered synthetic GHRH in a patient with acromegaly due to a GHRH secreting pancreatic tumor. The diagnosis was established by high peripheral IR-GHRH levels (1100 pg/ml) and an arterio- venous tumor gradient of IR-GHRH. In this patient GH failed to respond to 1 microgram/kg of exogenous GHRH with the pancreatic tumor in situ; however, further increase of serum GH levels occurred after TRH administration, hypoglycemia and oral glucose administration. After removal of the tumor, serum GH levels decreased and a normal response to GHRH and TRH were demonstrated. The extract of the tumor contained 1.7 micrograms IR-GHRH per g wet tissue. Thus, lack of response to exogenous GHRH in untreated acromegaly may indicate the presence of an ectopic GHRH producing tumor.
生长激素释放激素（GHRH）最近已从分泌GHRH的胰腺肿瘤中分离出来并进行了测序。因垂体肿瘤导致未经治疗的肢端肥大症患者，对外源性给予GHRH的反应是其基础生长激素（GH）水平进一步升高。我们首次报告了外源性给予合成GHRH对一名因分泌GHRH的胰腺肿瘤导致肢端肥大症患者的影响。诊断依据是外周血中高浓度的免疫反应性GHRH水平（1100 pg/ml）以及免疫反应性GHRH的动静脉肿瘤梯度。在该患者中，胰腺肿瘤原位时，GH对外源性1微克/千克GHRH无反应；然而，给予促甲状腺激素释放激素（TRH）、低血糖和口服葡萄糖后，血清GH水平进一步升高。肿瘤切除后，血清GH水平下降，并显示出对GHRH和TRH的正常反应。肿瘤提取物每克湿组织含1.7微克免疫反应性GHRH。因此，未经治疗的肢端肥大症对外源性GHRH无反应可能表明存在异位产生GHRH的肿瘤。
