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The case presented by Petzold et al in this issue highlights certain critical aspects of management of the child and adolescent with endocrine problems which are both of theoretical and practical interest. First, the discrepancy between the hormonal profile and the clinical manifestations, as described in this case, although not novel are, nevertheless, interesting and thought-provoking. It is evident that in this particular patient hypothalamic stimuli were not reaching the pituitary and consequently the pituitary hormones were not effectively stimulating other target glands. Among the various explanations for the apparent satisfactory clinical condition of this and other patients, despite the lack of therapy, could be the constitutive synthesis of the corresponding hormones by the unstimulated but intact target gland, giving rise to base-line hormone production, adequate for survival but not for well-being.

The liaison of the young endocrine patient with the adult endocrinologist. On the occasion of a prismatic case