Suppressive action of ACTH on growth hormone secretion in patients with infantile spasms

The changes in insulin-induced growth hormone secretion and in serum cortisol level were studied in 3 cases of West syndrome. The ACTH therapy consisted of an eight weeks course with gradual tapering every two weeks. Daily administration of 12.5 or 25.0 micrograms per kg ACTH for two weeks suppressed an insulin-induced rise in serum GH. The patients who showed sharply suppressed responses as to serum GH had been exposed to high cortisol levels of over 50 micrograms per dl serum. When they were examined before starting the therapy and 72 or 96 hours after the last ACTH injection, all the subjects showed a normal rise in the level of serum GH. The clinical implications of the findings were discussed in terms of the possible adverse effect on the developing brain.