
the effect of human growth hormone in
hypopituitary dwarfism
human growth hormone (hgh) raben has been
used in a dosage of 2 mg./m.2/day or 5 mg./m.2 twice
weekly.  this dosage is probably in or below, but
certainly not above, the range of physiological
replacement therapy.
in a standardized five-day metabolic hgh test
hypopituitary dwarfs retain more n than children
without gh deficiency.  this test is valuable
diagnostic help in hypopituitary dwarfism.
a prolonged treatment with hgh accelerates
growth in hypopituitary dwarfs but not in children
without gh deficiency.  growth rate, induced by
this treatment, is first above average and later average
or below average for age.  this decreasing response
to hgh is typical for the general phenomenon of
catch-up growth and is not caused by the develop-
ment of antibodies.
of 9 hypopituitary dwarfs, treated for at least 9
months, 3 were growth resistant from the beginning
in spite of a high n retention in the preceding hgh
test.  this resistance is caused by the development
of high titres of specific hgh antibodies in the very
first few months of treatment.  these antibodies
suppress the effect of hgh both on metabolism and
on growth.  the unexpected occasional induction in
man of antibodies against a homologous protein
hormone is of great interest.  the possibility that
these antibodies might be active not only against the
homogenous but also against the endogenous hormone
could have a far-reaching biological importance.
