[Functional changes of hypothalamic-pituitary target gland axes and their clinical significance].

We examined the function of hypothalamic-pituitary target gland axes in 88 cases with epidemic hemorrhagic fever (EHF). It was found that all the three endocrine axes i.e. hypothalamic-pituitary-adrenocortical axis, hypothalamic-pituitary-thyroid axis and hypothalamic- pituitary-gonadal axis showed some functional impairment. In acute phase there were increased plasma ACTH, FSH and LH levels, which might be attributed to stress reaction in EHF patients. Most cases showed low or weak response of TSH to TRH and delayed response of LH to LHRH; some of the cases did not respond to 1mg of glucagon. These manifestations might be related with poor reserve of anterior pituitary or to disordered regulation of endocrine axes. The increased plasma cortisol and estradiol and the decreased plasma T3, T4 as well as testosterone during acute phase may have important clinical significance. Hence we suggest that in any case glucocorticosteroids should not be abused and that in severe patients thyroxine and durabolin should be administered to improve immunity and hepato-renal function.