Similar Clinical Features Among Patients with Severe Adult Growth Hormone Deficiency Diagnosed with Insulin Tolerance Test or Arginine or Glucagon Stimulation Tests

2012 ◽  
Vol 18 (3) ◽  
pp. 325-334 ◽  
Author(s):  
Andrew Toogood ◽  
Georg Brabant ◽  
Dominique Maiter ◽  
Bjórn Jonsson ◽  
Ulla Feldt-Rasmussen ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Clinical Features ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Hormone Deficiency ◽  
Adult Growth Hormone Deficiency ◽  
Insulin Tolerance ◽  
Adult Growth ◽  
Stimulation Tests

scholarly journals Should Pediatric Endocrinologists Consider More Carefully When to Perform a Stimulation Test?

2021 ◽  
Vol 12 ◽  
Author(s):  
Arturo Penco ◽  
Benedetta Bossini ◽  
Manuela Giangreco ◽  
Viviana Vidonis ◽  
Giada Vittori ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Standard Dose ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Hormone Deficiency ◽  
Pediatric Endocrinology ◽  
Insulin Tolerance ◽  
Stimulation Tests ◽  
Lhrh Test

IntroductionPediatric endocrinology rely greatly on hormone stimulation tests which demand time, money and effort. The knowledge of the pattern of pediatric endocrinology stimulation tests is therefore crucial to optimize resources and guide public health interventions. Aim of the study was to investigate the distribution of endocrine stimulation tests and the prevalence of pathological findings over a year and to explore whether single basal hormone concentrations could have saved unnecessary stimulation tests.MethodsRetrospective study with data collection for pediatric endocrine stimulation tests performed in 2019 in a tertiary center.ResultsOverall, 278 tests were performed on 206 patients. The most performed test was arginine tolerance test (34%), followed by LHRH test (24%) and standard dose Synachthen test (19%), while the higher rate of pathological response was found in insulin tolerance test to detect growth hormone deficiency (81%), LHRH test to detect central precocious puberty (50%) and arginine tolerance test (41%). No cases of non-classical-congenital adrenal hyperplasia were diagnosed. While 29% of growth hormone deficient children who performed an insulin tolerance test had a pathological peak cortisol, none of them had central adrenal insufficiency confirmed at low dose Synacthen test. The use of basal hormone determinations could save up to 88% of standard dose Synachthen tests, 82% of arginine tolerance + GHRH test, 61% of LHRH test, 12% of tests for adrenal secretion.ConclusionThe use of single basal hormone concentrations could spare up to half of the tests, saving from 32,000 to 79,000 euros in 1 year. Apart from basal cortisol level <108 nmol/L to detect adrenal insufficiency and IGF-1 <-1.5 SDS to detect growth hormone deficiency, all the other cut-off for basal hormone determinations were found valid in order to spare unnecessary stimulation tests.

Glucagon Stimulation Testing in Adult Growth Hormone Deficiency— A 2014 Update

2014 ◽  
Vol 10 (01) ◽  
pp. 75
Author(s):  
Kevin C J Yuen ◽  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
The Elderly ◽  
Tolerance Test ◽  
Clinical Findings ◽  
Clinical Syndrome ◽  
Stimulation Test ◽  
Hormone Deficiency ◽  
Insulin Tolerance ◽  
Adult Growth

Growth hormone deficiency (GHD) is a well-recognized clinical syndrome in adults, and its diagnosis is established through one or more GH stimulation tests. The decision to perform GH stimulation testing should be based on medical history and clinical findings, and using appropriate GH stimulation test/s for biochemical confirmation. The insulin tolerance test (ITT) remains the diagnostic test of choice; however, this test is labor intensive, contraindicated in the elderly and in adults with seizure disorders and ischemic heart disease, can be unpleasant for the patient, and is potentially hazardous. With the discontinuation of the growth hormone releasing hormone (GHRH) analog (Geref®) in the US in 2008, the glucagon stimulation test (GST) has gained increasing popularity as the alternative test to the ITT because of its availability, reproducibility, safety, lack of influence by gender and hypothalamic cause of GH deficiency (GHD), and relatively few contraindications. In this article, recommendations for performing this test, the potential drawbacks in conducting and caveats in interpreting this test, and its future perspectives are discussed.

scholarly journals GROWTH HORMONE LEVELS AT INDUCED HYPOGLYCEMIA; AN EFFECTIVE WAY OF DIAGNOSING GROWTH HORMONE DEFICIENCY

2021 ◽  
Vol 71 (1) ◽  
pp. 184-89
Author(s):  
Nida Basharat Khan ◽  
Asif Ali Memon ◽  
Sumbal Nida ◽  
Naveed Asif ◽  
Saima Shakeel Malik ◽  
...  
Keyword(s):  
Growth Hormone ◽  
Growth Hormone Deficiency ◽  
Plasma Glucose ◽  
Tolerance Test ◽  
Insulin Tolerance Test ◽  
Hormone Deficiency ◽  
Inadequate Response ◽  
Post Induction ◽  
Adequate Response ◽  
Insulin Tolerance

Objective: To introduce a relatively convenient and effective way of conducting Insulin Tolerance Test for diagnosis of Growth Hormone deficiency in children with short stature. Study Design: Cross sectional analytical study. Place and Duration of Study: Conducted at Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Rawalpindi, from May 2017 to Jul 2018. Methodology: A total of 185 cases were included. Sample selection was done by non-probability consecutive sampling technique. Insulin tolerance test was performed by taking basal sample for serum growth hormone and plasma glucose levels before giving intravenous insulin bolus according to dose of 0.15 IU/kg. Samples for Growth Hormone level were repeated at time of induced hypoglycemia (defined as plasma glucose level of <2.8 mmol/L), 30 minutes and 60 minutes post induction. Results: Mean age of the patients was 10 ± 4 years, majority 120 (65%) were males. In the study population, 41 (22%) patients showed adequate response to insulin tolerance test while 144 (78%) showed inadequate response. At level of induction, mean growth hormone levels were 31.9 ± 18.8 mIU/l and 4.7 ± 4.4 mIU/l in patients showing adequate and inadequate response respectively (p-value <0.05). Majority 32 (78%) of the patients showing adequate response had peak growth hormone response (>20 mIU/l) at induction alone, followed by 30 minutes post induction; reflecting the significance of these two samples in diagnosis of growth hormone deficiency. Conclusion: We concluded that there is a simpler ...........

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