ABSTRACT
To test the hypothalamic pituitary adrenal axis in hepatosplenic schistosomiasis [HSS], 40 adult Egyptian males were selected. They were composed of 4 groups: Compensated HSS [G1], decompensated HSS [G2], HSS with bilateral gynecomastia [G3] and healthy controls [G4]. They were subjected to full clinical examination and routine laboratory tests in addition to the ACTH and cortisol levels in plasma before [basal level] and after insulin-induced hypoglycemia as a dynamic test. The basal level of plasma ACTH in patients with compensated HSS was found to be significantly lower than that of the control [P <0.05]. It was even lower in the controls and in HSS associated with gynecomastis [P <0.001]. After insulin induced hypoglycemia, the level of ACTH was found to be significantly low in G2 and G3 compared with the controls. The level after stimulation was higher than the basal level in all groups including the controls. On the other hand, the basal level of serum cortisol was significantly low in patients with gynecomastia only compared with the controls. While, after insulin induced hypoglycemia the levels were found to be significantly low in G1 and G3 [P <0.001]. No correlations were found between serum albumin, SGPT or alkaline phosphatase and ACTH or cortisol levels. These findings could have its own application when a patient with HSS should undergo a major surgery
Subject(s)
Humans , Male , Hypothalamic HormonesABSTRACT
The function of the hypothalamic pituitary gonadal axis was studied in males having hepatosplenic schistosomiasis, compensated group [1], decompensated group [2] or associated with some manifestations of endocrinal disturbances, such as gynecomastia [group 3]. A healthy group [4] was used as controls. Some pituitary and gonadal hormones were measured by radioimmunoassay at basal levels and after stimulation of the pituitary to release its reserve of FSH and LH by clomiphene citrate. The level of FSH was found to be significantly low in all patient groups before and after stimulation when compared with the confound to be significantly low in all patient groups before and after stimulation when compared with the controls. The basal level of LH was found to be low only in group 3, but after stimulation it was low in groups 2 and 3. Furthermore, there was a direct correlation between FSH and LH levels in group 3 [with gynecomastia] only. Serum levels of testosterone were found to be low in all groups before and after stimulation. A significant positive correlation was found between basal levels of FSH and testosterone in group 1 and a negative correlation in group 2. Serum prolactin was found to be high in all patient groups before stimulation and in group 3 only after stimulation. On the other hand, serum progesterone was found to be low in group 1 and high in group 3 before and after clomiphene stimulation. Moreover, no correlation was detected between estradiol and progesterone. These findings could be explained on the bases of the effect of estradiol, which is the most biologically strong estrogen. The sustained hyperestrogenism could lead to suppression of the pituitary gland, which is the master gland and plays the role of pacemaker of the endocrine system