Effect of Pyrogen on Blood Levels of Pituitary Trophic Hormones. Observations of the Usefulness of the Growth Hormone Response in the Detection of Pituitary Disease

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Abstract
The effect of pyrogen on plasma GH, LH, TSH and cortisol levels has been measured in 17 normal subjects, 13 patients with pituitary disease, and 3 patients with primary hypothyroidism. In 16 of the 17 normal subjects the plasma GH was greater than 10 mμg/ml at some time during the test, and plasma cortisol level increased by at least 5 mμg/100 ml. The GH response was not suppressed by glucose infusion in 2 subjects. Pyrogen did not cause an increase in LH or TSH in any subject. The TSH levels in 3 patients with primary hypothyroidism decreased 1 hr after pyrogen at the same time that plasma GH levels were elevated. These data show that pyrogen is not a nonspecific stimulus to the hypothalamic-pituitary system causing release of all polypeptide hormones. Growth hormone levels of greater than 10 mμg/ml after pyrogen occurred in only 1 of 13 patients with pituitary disease. In 8 of the 13 patients, however, the plasma cortisol increment was greater than 5 μg/100 ml. Thus, measurement of plasma GH in response to pyrogen increases the sensitivity of the test for the detection of pituitary disease.