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August 7, 1954, Vol 155, No. 15 >
ARTICLE | August 7, 1954

THE STARVATION STATE AND FUNCTIONAL HYPOPITUITARISM FREE

William H. Perloff, M.D.; Eunice M. Lasché, M.D.; John H. Nodine, M.D.; Norman G. Schneeberg, M.D.; Carol B. Vieillard, M.D.
[+] Author Affiliations

Corticotropin (Acthar) and thyroid-stimulating hormone (Thytropar) used in this study were supplied by Armour & Co.

The persons in cases 1 and 2 were the patients of Drs. Stewart and Kremer.


Philadelphia

From the Endocrine Clinics and Medical Wards of the Philadelphia General Hospital and the Endocrine Department of the Temple University School of Medicine.


JAMA. 1954;155(15):1307-1313. doi:10.1001/jama.1954.03690330011004
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References

The tendency of severe states of nutritional deficiency to alter the function of various endocrine glands has been observed in both human beings and experimental animals. The similarity of the clinical picture produced by extreme degrees of malnutrition to that following destruction of the anterior lobe of the pituitary gland continues to be a source of confusion and error in the differentiation between these two conditions. Escamilla and Lisser,1 in their review of 595 cases of possible hypopituitary cachexia (Simmonds' disease), have commented on the frequency with which this syndrome has been mistaken for anorexia nervosa, and various laboratory tests or groups of tests have been recommended by many authors to facilitate the differential diagnosis. In order to evaluate the efficacy of such studies, an endocrine survey was performed on five selected patients with unusually severe starvation states, four of whom were comparatively young adults, and the results of

REFERENCES

1 +
Escamilla, R. F., and Lisser, H.:  Simmonds' Disease: A Clinical Study with Review of the Literature: Differentiation from Anorexia Nervosa by Statistical Analysis of 595 Cases, 101 of Which Were Proved Pathologically , J. Clin. Endocrinol. 2:65, 1942;.
2 +
Perloff, W. H.; Levy, L. M., and Despopoulos, A.:  The Use of Thyrotropic Hormone (TSH) in the Diagnosis of Myxedema , J. Clin. Endocrinol. 11:1495, 1951;.
3 +
Jacobs, E. C.:  Effects of Starvation on Sex Hormones in the Male , J. Clin. Endocrinol. 8:227, 1948;.
4 +
Hultgren, H. N.:  Clinical and Laboratory Observations in Severe Starvation , Stanford M. Bull . 9:175, 1951;.
5 +
Lamy, M.; Lamotte, M., and Lamotte-Barrillon, S.:  Glandes endocrines et dénutrition , Ann. d'endocrinol. 8:437, 1947;.
6 +
Sealander, J. A., Jr.:  Effect of Environmental Temperature and Starvation on Adrenal Glands of the White-Footed Mouse , Am. J. Physiol. 163: 92, 1950;.
7 +
D'Angelo, S. A.; Gordon, A. S., and Charipper, H. A.:  The Effect of Inanition on the Anterior Pituitary-Adrenocortical Interrelationship in the Guinea Pig , Endocrinology 42:399, 1948;.
8 +
Mulinos, M. G., and Pomerantz, L.:  Hormonal Influences on the Weight of the Adrenal in Inanition , Am. J. Physiol. 132:368, 1941;.
9 +
Meyers, A. W.:  Some Morphological Effects of Prolonged Inanition , J. M. Research 36:51, 1917;.
10 +
Sheehan, H. L., and Summers, V. K.:  The Syndrome of Hypopituitarism , Quart. J. Med. 18:319, 1949;.
11 +
Chambers, W. H.:  Undernutrition and Carbohydrate Metabolism , Physiol. Rev. 18:248, 1938;.
12 +
Chakrabarty, M. L.:  Blood Sugar Levels in Slow Starvation , Lancet 1:596, 1948;.
13 +
Farquharson, R. F., and Hyland, H. H.:  Anorexia Nervosa , J. A. M. A. 111:1085 ( (Sept. 17) ) 1938;.
14 +
Simmonds, M.:  Ueber Hypophysisschwund mit tödlichem Ausgang , Deutsche med. Wchnschr. 40:322, 1914;.
15 +
Sheehan and Summers.9
16 +
Sheehan, H. L.:  Post-Partum Necrosis of the Anterior Pituitary , J. Path. & Bact. 45: 189, 1937;.
17 +
Sheehan and Summers.9
18 +
Lasché, E. M., and Perloff, W. H.:  Clinical Signs and Symptoms in Four Cases of Hypopituitarism with Autopsy Findings , J. Phila. Gen. Hosp. 2: 121, 1951;.
19 +
Escamilla and Lisser.1
20 +
Sheehan.14a

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

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1 +
Escamilla, R. F., and Lisser, H.:  Simmonds' Disease: A Clinical Study with Review of the Literature: Differentiation from Anorexia Nervosa by Statistical Analysis of 595 Cases, 101 of Which Were Proved Pathologically , J. Clin. Endocrinol. 2:65, 1942;.
2 +
Perloff, W. H.; Levy, L. M., and Despopoulos, A.:  The Use of Thyrotropic Hormone (TSH) in the Diagnosis of Myxedema , J. Clin. Endocrinol. 11:1495, 1951;.
3 +
Jacobs, E. C.:  Effects of Starvation on Sex Hormones in the Male , J. Clin. Endocrinol. 8:227, 1948;.
4 +
Hultgren, H. N.:  Clinical and Laboratory Observations in Severe Starvation , Stanford M. Bull . 9:175, 1951;.
5 +
Lamy, M.; Lamotte, M., and Lamotte-Barrillon, S.:  Glandes endocrines et dénutrition , Ann. d'endocrinol. 8:437, 1947;.
6 +
Sealander, J. A., Jr.:  Effect of Environmental Temperature and Starvation on Adrenal Glands of the White-Footed Mouse , Am. J. Physiol. 163: 92, 1950;.
7 +
D'Angelo, S. A.; Gordon, A. S., and Charipper, H. A.:  The Effect of Inanition on the Anterior Pituitary-Adrenocortical Interrelationship in the Guinea Pig , Endocrinology 42:399, 1948;.
8 +
Mulinos, M. G., and Pomerantz, L.:  Hormonal Influences on the Weight of the Adrenal in Inanition , Am. J. Physiol. 132:368, 1941;.
9 +
Meyers, A. W.:  Some Morphological Effects of Prolonged Inanition , J. M. Research 36:51, 1917;.
10 +
Sheehan, H. L., and Summers, V. K.:  The Syndrome of Hypopituitarism , Quart. J. Med. 18:319, 1949;.
11 +
Chambers, W. H.:  Undernutrition and Carbohydrate Metabolism , Physiol. Rev. 18:248, 1938;.
12 +
Chakrabarty, M. L.:  Blood Sugar Levels in Slow Starvation , Lancet 1:596, 1948;.
13 +
Farquharson, R. F., and Hyland, H. H.:  Anorexia Nervosa , J. A. M. A. 111:1085 ( (Sept. 17) ) 1938;.
14 +
Simmonds, M.:  Ueber Hypophysisschwund mit tödlichem Ausgang , Deutsche med. Wchnschr. 40:322, 1914;.
15 +
Sheehan and Summers.9
16 +
Sheehan, H. L.:  Post-Partum Necrosis of the Anterior Pituitary , J. Path. & Bact. 45: 189, 1937;.
17 +
Sheehan and Summers.9
18 +
Lasché, E. M., and Perloff, W. H.:  Clinical Signs and Symptoms in Four Cases of Hypopituitarism with Autopsy Findings , J. Phila. Gen. Hosp. 2: 121, 1951;.
19 +
Escamilla and Lisser.1
20 +
Sheehan.14a

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