Oral Clonidine Provocative Test in the Diagnosis of Growth Hormone Deficiency in Childhood: Should We Make the Timing Uniform?

2006 ◽  
Vol 66 (6) ◽  
pp. 285-288 ◽  
Author(s):  
Fiorella Galluzzi ◽  
Stefano Stagi ◽  
Maria Parpagnoli ◽  
Stefania Losi ◽  
Ilaria Pagnini ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Hormone Deficiency ◽  
Provocative Test ◽  
Oral Clonidine

scholarly journals IGF-1 and IGFBP 3 in Growth Hormone Deficiency Role of Insulin Like Growth Factor-1 (IGF-1) and IGF Binding Protein 3 in the Diagnosis of Growth Hormone Deficiency: Changing Paradigm

2012 ◽  
Vol 32 (2) ◽  
pp. 154-162 ◽  
Author(s):  
SK Kota ◽  
S Jammula ◽  
K Gayatri ◽  
SK Kota ◽  
PR Tripathy ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Gh Deficiency ◽  
False Positive Rate ◽  
Hormone Deficiency ◽  
Provocative Test ◽  
Definitive Evidence ◽  
Gh Secretion ◽  
Igf I ◽  
Igfbp 3

GH stimulation tests are widely used in the diagnosis of GH deficiency (GHD), although they are associated with a high false positive rate. Serum IGF-I levels are monitored during GH replacement treatment in subjects with GH deficiency (GHD) to guide GH dose adjustment and to minimize occurrence of GHrelated side-effects. The need for reliance on provocative testing is based on evidence that the evaluation of spontaneous growth hormone (GH) secretion over 24 hours and the measurement of IGF-I and IGFBP-3 levels do not distinguish between normal and GHD subjects. Regarding IGF-I, it has been demonstrated that very low levels in patients highly suspected for GHD (i.e., patients with childhood-onset, severe GHD, or with multiple hypopituitarism acquired in adulthood) may be considered definitive evidence for severe GHD obviating the need for provocative tests. However, normal IGF-I levels do not rule out severe GHD and therefore adults suspected for GHD and with normal IGF-I levels must undergo a provocative test of GH secretion. We hereby review the various literatures at disposal justifying the use of IGF-1 and IGBP3 for diagnosis of growth hormone deficiency.Data Source: We searched PUBMED and MEDLINE database for relevant articles including key words. References of each article were further reviewed for final synthesis of the manuscript.J Nepal Paediatr Soc 2012;32(2):154-162 doi: http://dx.doi.org/10.3126/jnps.v32i2.5342

Diagnosis of Growth Hormone Deficiency in Children: The Efficacy of Glucagon versus Clonidine Stimulation Test

2021 ◽  
pp. 1-7
Author(s):  
Michal Yackobovitch-Gavan ◽  
Liora Lazar ◽  
Rotem Diamant ◽  
Moshe Phillip ◽  
Tal Oron
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Stimulation Test ◽  
Population Characteristics ◽  
Hormone Deficiency ◽  
Confirmatory Test ◽  
Diagnostic Efficacy ◽  
Provocative Test ◽  
Short Children ◽  
Confirmatory Tests

<b><i>Introduction:</i></b> The diagnosis of childhood growth hormone deficiency (GHD) requires a failure to respond to 2 GH stimulation tests (GHSTs) performed with different stimuli. The most commonly used tests are glucagon stimulation test (GST) and clonidine stimulation test (CST). This study assesses and compares GST and CST’s diagnostic efficacy for the initial evaluation of short children. <b><i>Methods:</i></b> Retrospective, single-center, observational study of 512 short children who underwent GHST with GST first or CST first and a confirmatory test with the opposite stimulus in cases of initial GH peak &#x3c;7.5 ng/mL during 2015–2018. The primary outcome measure was the efficacy of the GST first or CST first in diagnosing GHD. <b><i>Results:</i></b> Population characteristics include median age of 9.3 years (interquartile range 6.2, 12.1), 78.3% prepubertal, and 61% boys. Subnormal GH response in the initial test was recorded in 204 (39.8%) children: 148 (45.5%) in GST first and 56 (30%) in CST first, <i>p</i> &#x3c; 0.001. Confirmatory tests verified GHD in 75/512 (14.6%) patients. Divergent results between the initial and confirmatory tests were more prevalent in GST first than CST first (103/148 [69.6%] vs. 26/56 [46.4%], <i>p</i> &#x3c; 0.001) indicating a significantly lower error rate for the CST first compared to the GST first. In multivariate analysis, the only significant predictive variable for divergent results between the tests was the type of stimulation test (OR = 0.349 [95% CI 0.217, 0.562], <i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> Screening of GH status with CST first is more efficient than that with GST first in diagnosing GHD in short children with suspected GHD. It is suggested that performing CST first may reduce the need for a second provocative test and avoid patients’ inconvenience of undergoing 2 serial tests.

Diagnosis of Growth Hormone Deficiency by Using the Arginine Provocative Test: Is It Possible to Shorten Testing Time without Altering Validity?

2009 ◽  
Vol 72 (3) ◽  
pp. 142-145 ◽  
Author(s):  
Fiorella Galluzzi ◽  
Maria Rita Quaranta ◽  
Roberto Salti ◽  
Stefano Stagi ◽  
Laura Nanni ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Hormone Deficiency ◽  
Testing Time ◽  
Provocative Test
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