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J Immunogenet 1976;3:36772. The major role of PTH is to tightly regulate extracellular Ca concentration and keep it within narrow limits.

Riskfactors,diagnosticstudies,andtreatmentoptions Disorder Highest risk Diagnostic studies Treatment options GH deficiency Gonadotropin deficiency Precocious puberty TSH deficiency ACTH deficiency Hyper-prolactinemia Diabetes insipidus Osteopenia Hypothalamic obesity 18GyCRT Pre-transplant CRT TBI Young age Tumor near HPA Hydrocephalus 30GyCRT Tumor near HPA 1824 Gy CRT Female Young age Tumor near HPA 30GyCRT TBI Tumor near HPA Hydrocephalus 30GyCRT Tumor near HPA Hydrocephalus 50GyCRT Tumor near HPA Histiocytosis Germinomas Tumor or tumor- related cysts near HPA Low GH, TSH, or LHFSH High prolactin Young age (6 years) 50Gy(hypothalamus) Tumor near HPA IGF-1, IGFBP-3 GH stimulation tests LH, FSH, estradiol, or testosterone (4to8AM) Bone age GnRH stimulation test LH, FSH, estradiol or testosterone (4to8AM) Bone age radiograph Pelvic ultrasound (female) GnRH stimulation test GH stimulation test Free T4, TSH (8 AM) Nocturnal TSH surge TRH stimulation test Cortisol (8 AM) Adrenal stimulation test Prolactin Simultaneous serum and urine osmolarity after 812 hours without fluid intake DEXA or quantitative CT Fasting insulin and glucose Oralglucosetolerancetest with insulin levels Recombinant GH GHRH GnRH agonist (if pubertal maturity too advanced for height) Estrogen progestin (women) Testosterone (men) GnRH agonist L-thyroxine Hydrocortisone Dopamine agonists Desmopressin Calcium vitamin D bisphosphonates Diet and exercise RitalinorDexedrine Metformin (monitor for hypoglycemia) Octreotide GH, growth hormone; CRT, cranial radiation therapy; TBI, total body irradiation; HPA, hypothalamicpituitary axis; IGF-1, insulin- like growth factor 1; IGFBP3, IGF binding protein 3; GHRH, growth hormone-releasing hormone; GnRH, gonadotropin-releasing hormone; LH, luteinizing hormone; FSH, follicle-stimulating hormone; T4, thyroxine; TSH, thyroid-stimulating hormone; TRH, thyrotropin-releasing hormone; ACTH, adrenocorticotrophin Chapter 1 Urological Problems in Pregnancy 13 27.

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