Spitz I M, Landau H, Almaliach U, Rosen E, Brautbar N, Russell A
J Clin Endocrinol Metab. 1977 Sep;45(3):412-8. doi: 10.1210/jcem-45-3-412.
A 17 year old male patient presented with short stature and delayed puberty. Investigations showed normal thyroid function and intact TSH response to TSH-releasing hormone (TRH). Although basal levels of LH were low, both LH and FSH rose following the administration of LH-releasing hormone (LHRH). ACTH secretion assessed indirectly by the cortisol response to insulin hypoglycemia was normal. Growth hormone levels increased following the onset of sleep, as well as after the administration of insulin, L-dopa and L-arginine. Basal levels of prolactin were low (2-5 ng/ml) compared with 5-12 ng/ml in controls. There was a markedly impaired prolactin response to TRH (maximum rise above basal values of 3 ng/ml compared to a rise of 12-29 ng/ml in controls). Prolactin levels did not rise after the administration of chlorpromazine or L-arginine. There was some suppression of prolactin levels after L-dopa. Similar patterns of prolactin are seen in panhypopituitarism, where they are usually associated with other hypophyseal hormonal deficiencies. The diminished prolactin reserve demonstrated in this subject in the presence of intact function of the remainder of the anterior pituitary is compatible with the diagnosis of diminished prolactin reserve.
一名17岁男性患者，身材矮小且青春期发育延迟。检查显示甲状腺功能正常，促甲状腺激素（TSH）对促甲状腺激素释放激素（TRH）的反应完整。虽然促黄体生成素（LH）的基础水平较低，但给予促黄体生成素释放激素（LHRH）后，LH和促卵泡生成素（FSH）均升高。通过胰岛素低血糖刺激后的皮质醇反应间接评估的促肾上腺皮质激素（ACTH）分泌正常。生长激素水平在睡眠开始后以及给予胰岛素、左旋多巴和左旋精氨酸后升高。与对照组5 - 12 ng/ml相比，催乳素的基础水平较低（2 - 5 ng/ml）。催乳素对TRH的反应明显受损（与对照组相比，基础值以上的最大升高为3 ng/ml，而对照组升高为12 - 29 ng/ml）。给予氯丙嗪或左旋精氨酸后催乳素水平未升高。左旋多巴给药后催乳素水平有所下降。全垂体功能减退时也可见类似的催乳素模式，通常与其他垂体激素缺乏有关。在该患者中，尽管垂体前叶其余部分功能正常，但催乳素储备减少，这与催乳素储备减少的诊断相符。
