[Recent advances in hormonal detection of pituitary somatotropic adenomas (author's transl)]

The primary role of either the hypothalamus or pituitary in the origin of acromegaly has still to be determined, but some interesting progress has been made in the hormonal detection of pituitary somatotropic adenomas over recent years. The most valid explorations remain assays of basal GH and somatomedin levels, and the absence of blocking of GH by glucose. Abnormal and/or paradoxical responses to certain dynamic tests are seen with variable frequency: stimulation of GH by TRH (62.9 p. cent), or by LH-RH (35.9 p. cent), and bromocriptive blocking (70.8 p. cent). These findings could be of diagnostic value in the rare cases when the results of biological tests are inconclusive (basal GH levels normal, apparent persistence of the GH nycterohemeral cycle, or even blocking of GM by glucose). Other tests of stimulation or blocking proposed for the investigation of acromegaly are reviewed, but these are non-specific, non-reproducible, and give unreliable results.