
   experiences with hgh treatment of twelve hypopituitary
dwarfs for periods varying from 6 to 41 months
are reported.  all the patients were considered to have
hypopituitarism from birth, four of them of the hereditary
type, four possibly due to traumatic birth or neonatal asphyxia,
and four from an unknown cause.  in six
patients detailed information concerning growth during
the first year of life could be obtained.  all of these patients
had a degree of growth retardation before one
year of age.  we consider this to be the rule rather than
the exception in pituitary dwarfism.  the most important
diagnostic evidence was a marked degree of growth retardation
accompanied by a pronounced delay in skeletal
maturation, and, in most cases, signs of secondary
hypothyroidism, increased insulin sensitivity, and a
poor response to metopyrone administration.  none of
the patients who had passed the normal age of puberty
had maturated sexually.  all twelve patients responded
well to hgh therapy.  during the first year of treatment
the average height increment was 10 cm. ('catch-up' growth).
with continued treatment a normal rate of
growth, about 6 cm./year, was obtained.  there was no
disproportionate acceleration of skeletal maturation in
any of the patients.  none of them has so far become resistant
to hgh administration.  the oldest patient has
reached normal height.  whether this will be possible
not only in the moderately severe, but also in the most
severe cases of pituitary dwarfism, can not yet be stated.
the possibility of using human gonadotrophic hormones
in an attempt to produce sexual maturation in
these patients is discussed briefly.
