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Endocrine dysfunction in the diencephalic syndrome of emaciation in infancy.

A 10-month-old boy with the clinical features of the diencephalic syndrome of emaciation due to a suprasellar spongioblastoma is described. The patient showed high basal levels of growth hormone (GH greater than 80 muU/ml on several occasions). In addition, elevated concentration of plasma testosterone (125.5 ng/100ml) was combined with a relatively high LH-increase to LHRH (45.6 mU/ml). After completion of irradiation basal GH-levels had been normalized, and GH responses to insulin induced hypoglycemia (IIH) and propranolol-glucagon (PG) were adequate. Complete clinical remission of emaciation occurred soon after radiation therapy and went parallel with the normalization of GH-regulation.

Astrocytoma

[The differential diagnosis of anorexia nervosa. Coincidence of somatic disease and psychogenic emaciation (author's transl)].

Three female patients with cachexia are reported in whom a psychogenic emaciation (anorexia nervosa) had been assumed. The postpubertal onset of the disease, deliberate limitation of diet, vomiting and subsequent emaciation and--in 2 patients--amenorrhea, as well as demonstrable experience of conflict supported this. The disease ran a lethal course. Autopsy revealed serious somatic diseases (stenosis of the ileum in two cases and brain tumor in one); their symptoms had been largely overlapped by those of anorexia nervosa.

Adolescent