Antagonism by Cortisone of the Linear Growth Induced in Hypopituitary Patients and Hypophysectomized Rats by Human Growth Hormone1

An 18-yr-old panhypopituitary male failed to grow while receiving “physiologic” doses of desiccated thyroid, cortisone and human growth hormone (HGH). A growth response began within 2 weeks of discontinuing cortisone acetate (2.5 mg tid). The second patient was an 18½-yr-old hypopituitary female who had maintained a normal growth rate during 27 months of HGH therapy. Cortisone acetate (5 mg tid) caused complete cessation of growth over the 3½-month period of administration. Growth promptly resumed when cortisone was discontinued. Studies with hypophysectomized rats treated with HGH and varying doses of cortisone confirmed these clinical observations and indicated that cortisone competitively inhibits growth hormone. It is concluded that concurrent administration of cortisone limits the beneficial growth-promoting effects of HGH in hypopituitary subjects. Furthermore, these observations probably explain in part the growth inhibition seen in treatment of normal children with pharmacologic doses of corticosteroids.