Transient XXXX caused by critical illness.

@entity1 @entity1545 @entity131 @entity251 @entity16 @entity542 @entity1887 @entity772 @entity1504 @entity53 @entity1176 @entity6126 @entity583
The effects of acute severe illness on pituitary-gonadal function were determined in 35 @entity1 and 19 @entity1 , including 12 who were postmenopausal. Seventeen @entity1 and 5 @entity1 had @entity131 which resulted in @entity772 . Twelve postmenopausal and 2 premenopausal @entity1 had @entity1504 . Eleven @entity1 had @entity583 , while 7 @entity1 underwent elective surgery. Serial plasma samples were examined for @entity251 ( @entity1 ), percentage of ultrafiltrable @entity251 ( @entity1 ), @entity53 ( @entity1 ), sex hormone-binding globulin, LH, and FSH. In @entity1 , mean @entity251 levels fell by 271 +/- 72 (+/- SE), 202 +/- 63 and 195 +/- 75 ng/dl within 24 h of @entity1545 , @entity583 , or elective surgery, representing decreases of 55%, 43%, and 58%. Further declines occurred in the first and third groups to mean nadirs of 93 +/- 16 and 117 +/- 5 ng/dl, respectively. During recovery of neurological function there was no correlation between the @entity251 level and the degree of @entity16 ; @entity251 levels eventually returned to normal (627 +/- 77 ng/ml). The percentage of ultrafiltrable @entity251 and sex hormone-binding globulin did not change in any group. Although significant decreases in mean immunoreactive LH and FSH levels were found after @entity542 , and decreases in FSH were found in the @entity1 after surgery, these changes occurred after the decline in @entity251 . Despite the fall in basal gonadotropin levels in the @entity542 group, there were no significant differences in the gonadotropin responses to @entity1176 (100 micrograms) in 4 @entity1 during their acute illness or recovery. LH, FSH, and @entity53 levels in the premenopausal @entity1 were significantly lower on the second day of @entity1545 (LH, 10.3 +/- 4.7 vs. 3.5 +/- 0.6 mIU/ml; FSH, 3.8 +/- 1.9 vs. 1.4 +/- 0.8 mIU/ml, @entity53 , 200 +/- 41 vs. 102 +/- 16 pg/ml) and remained suppressed for 7 days. Gonadotropin levels also fell in the postmenopausal @entity1 within 24 h; reductions in LH of 74% and in FSH of 62% were present by day 7 of study. We conclude that both @entity1 and @entity1 who are critically ill uniformly develop @entity1887 regardless of their illness. In @entity1 , it is manifested by low @entity251 levels, while a comparable decrease in @entity53 is present in @entity1 . The low @entity251 concentrations are not due to reduced sex hormone-binding capacity. Based upon our data in postmenopausal @entity1 , @entity6126 also occurs in the presence of nonfunctioning gonads. Although our studies do not completely establish the pathophysiology of this disorder, they suggest a suprapituitary origin.
