Is growth hormone stimulation testing in children still appropriate?
The diagnosis of growth hormone deficiency (GHD) historically has relied on measurement of growth hormone (GH) concentrations following stimulation, usually with a non-physiologic provocative agent. Despite the use of more specific GH assays, the peak concentration of GH below which a child is considered GH deficient has risen. We examine the pitfalls associated with GH stimulation tests, specifically, the lack of reliability and accuracy of these tests, and their inability to predict who will benefit from GH therapy. We recommend that GH stimulation tests no longer routinely be used for the diagnosis of GHD in children.
Gandrud
Laura M
LM
Division of Pediatric Endocrinology and Diabetes, Stanford University Medical Center, S-302, Stanford University, Stanford, CA 94305-5208, USA. Lgandrud@stanford.edu
Wilson
Darrell M
DM
D002648:Child; D003677:Deficiency Diseases / Q000175:diagnosis / Q000188:drug therapy; D004393:Dwarfism, Pituitary / Q000175:diagnosis / Q000188:drug therapy; D019382:Human Growth Hormone / Q000097:blood* / Q000172:deficiency* / Q000627:therapeutic use; D006801:Humans; D010901:Pituitary Function Tests / Q000941:ethics* / Q000379:methods; D015203:Reproducibility of Results
D019382:Human Growth Hormone