Disorders of growth hormone and corticotropin regulation in patients with empty sella

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Abstract
✓ Endocrine functions in seven cases of primary empty sella were studied. No clinical features of endocrine disturbances were apparent. Urinary excretion of gonadotropins, and thyroid and adrenal functions were normal. Plasma human growth hormone (HGH) concentration was also normal but did not increase after insulin-induced hypoglycemia in four patients, after arginine in one, and after a glucose load in six. Urinary excretion of 17-hydroxycorticosteroids (17-OHCS) increased normally in all patients after metyrapone administration, while plasma 17-OHCS did not increase in three subjects after insulin-induced hypoglycemia or in one after lysine-vasopressin. Two patients showed exaggerated responses to lysine-vasopressin. These results indicate an impairment of the hypothalamic HGH and corticotropin regulation in patients with empty sella. Since in chromophobe adenomas comparable changes were seen, the differential diagnosis between empty sella and chromophobe adenoma is impossible on the basis of endocrino...