Growth Hormone Secretion in Congenital Adrenal Hyperplasia

Plasma growth hormone and corticoid concentrations were determined every 20 min for 24 hr in 2 children, ages 5-10/12 and 8-6/12, with congenital adrenal hyperplasia (one 21-hydroxylase and one 11-hydroxylase deficiency) and in three normal children. Plasma growth hormone and corticoids were measured for 5 hr in another child with congenital adrenal hyperplasia (21-hydroxylase deficiency). The 24-hr growth hormone secretory pattern in the patients with adrenal hyperplasia was the same as that seen in normal adolescents in early puberty. These two patients secreted more growth hormone than normal prepubertal children with the same chronological ages. The rapid growth seen in untreated congenital adrenal hyperplasia may be related to the increased secretion of growth hormone for the patients age. Corticoid secretion was markedly increased in all patients. There were periods of secretion of corticoids during which no growth hormone was secreted in both patients and control subjects. The control of secretion of growth hormone and corticoids thus seem to be governed by different mechanisms. However, as normal puberty progresses there is an increasing number of growth hormone secretory episodes without a significant change in the number of corticoid secretory episodes, and there may be a fortuitous coincidence of secretion of both corticoids and growth hormone in both the normal subject and the patient with congenital adrenal hyperplasia in advanced puberty.