Early retesting by GHRH + arginine test shows normal GH response in most children with idiopathic GH deficiency

2014 ◽  
Vol 38 (4) ◽  
pp. 429-436 ◽  
Author(s):  
C. Bizzarri ◽  
S. Pedicelli ◽  
B. Boscherini ◽  
G. Bedogni ◽  
M. Cappa ◽  
...  
Keyword(s):  
Gh Deficiency ◽  
Arginine Test

scholarly journals Diagnostic value of a ghrelin test for the diagnosis of GH deficiency after subarachnoid hemorrhage

2013 ◽  
Vol 169 (4) ◽  
pp. 497-502 ◽  
Author(s):  
K Blijdorp ◽  
L Khajeh ◽  
G M Ribbers ◽  
E M Sneekes ◽  
M H Heijenbrok-Kal ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Adverse Events ◽  
Gh Deficiency ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
False Positive Rate ◽  
Diagnostic Value ◽  
Secondary Outcome ◽  
Operating Characteristics ◽  
Provocative Test ◽  
Arginine Test

ObjectiveTo determine the diagnostic value of a ghrelin test in the diagnosis of GH deficiency (GHD) shortly after aneurysmal subarachnoid hemorrhage (SAH).DesignProspective single-center observational cohort study.MethodsA ghrelin test was assessed after the acute phase of SAH and a GH-releasing hormone (GHRH)–arginine test 6 months post SAH. Primary outcome was the diagnostic value of a ghrelin test compared with the GHRH–arginine test in the diagnosis of GHD. The secondary outcome was to assess the safety of the ghrelin test, including patients' comfort, adverse events, and idiosyncratic reactions.ResultsForty-three survivors of SAH were included (15 males, 35%, mean age 56.6±11.7). Six out of 43 (14%) SAH survivors were diagnosed with GHD by GHRH–arginine test. In GHD subjects, median GH peak during ghrelin test was significantly lower than that of non-GHD subjects (5.4 vs 16.6,P=0.002). Receiver operating characteristics analysis showed an area under the curve of 0.869. A cutoff limit of a GH peak of 15 μg/l corresponded with a sensitivity of 100% and a false-positive rate of 40%. No adverse events or idiosyncratic reactions were observed in subjects undergoing a ghrelin test, except for one subject who reported flushing shortly after ghrelin infusion.ConclusionOwing to its convenience, validity, and safety, the ghrelin test might be a valuable GH provocative test, especially in the early phase of SAH.

Different degrees of GH deficiency evidenced by GHRH+arginine test and IGF-I levels in adults with pituritary disease

2005 ◽  
Vol 28 (5) ◽  
pp. 247-252 ◽  
Author(s):  
G. Aimaretti ◽  
G. Corneli ◽  
C. Di Somma ◽  
R. Baldelli ◽  
V. Gasco ◽  
...  
Keyword(s):  
Gh Deficiency ◽  
Arginine Test ◽  
Igf I

scholarly journals Central reassessment of GH concentrations measured at local treatment centers in children with impaired growth: consequences for patient management

2004 ◽  
pp. 291-297 ◽  
Author(s):  
BP Hauffa ◽  
N Lehmann ◽  
M Bettendorf ◽  
O Mehls ◽  
HG Dorr ◽  
...  
Keyword(s):  
Patient Management ◽  
Gh Deficiency ◽  
Local Treatment ◽  
Diagnostic Group ◽  
Serum Samples ◽  
Insulin Hypoglycemia ◽  
Arginine Test ◽  
Reference Center ◽  
The Mean ◽  
Serum Gh

OBJECTIVE: GH deficiency is diagnosed in children if serum GH fails to rise above a predefined cutoff value in response to at least two stimuli. Diagnostic decisions based on this testing are highly variable between centers and depend on the GH assays used. Considering the large spectrum of commercially available GH assays, we wanted to evaluate the agreement between assays, and to test whether assay-related variability of diagnostic decisions could be reduced by reassessment of peak GH concentrations in a reference center. DESIGN: We reanalysed 699 peak GH serum samples obtained after GH testing of 382 children and adolescents from 19 centers using three reference assays and compared these results with those obtained with the local assays. A subgroup of 132 patients tested with the combination of insulin hypoglycemia test and arginine test was evaluated for changes in the assignment to the diagnostic group of GH deficiency. RESULTS: The mean difference between methods ranged from 5.4 to 10.3 mU/l, slopes of the regression lines from 1.28 to 1.65. Significant non-linearity was detected in five of six assay comparisons, indicating that most assay results cannot be interconverted by the use of a factor. Overall agreement between reference and local assays was only moderate. Significant changes in diagnostic assignment occurred when different assays were used on the same patient (P<0.0001-P<0.0023). Based on GH remeasurement by one reference assay, 36 of 132 patients were categorized differently, with 35 patients changing into the GH-deficient group. Similar findings were obtained with the other reference assays. CONCLUSIONS: To decrease variability in GH testing related to assays and cutoff values, we recommend nationwide reassessment of GH peak sera in reference centers. Decisions to treat GH deficiency should incorporate the reference center results.

A highly sensitive sandwich enzyme immunoassay of urinary growth hormone in children with short stature, Turner's syndrome, and simple obesity

1989 ◽  
Vol 121 (4) ◽  
pp. 513-519 ◽  
Author(s):  
Hiroshi Tomita ◽  
Masamichi Ogawa ◽  
Takashi Kamijo ◽  
Osamu Mori ◽  
Eiji Ishikawa ◽  
...  
Keyword(s):  
Short Stature ◽  
Enzyme Immunoassay ◽  
Gh Deficiency ◽  
Urine Samples ◽  
Turner's Syndrome ◽  
Turner’S Syndrome ◽  
Highly Sensitive ◽  
Significant Difference ◽  
Simple Obesity ◽  
Sandwich Enzyme Immunoassay

Abstract. GH values were determined by a highly sensitive sandwich enzyme immunoassay in the 1st morning and/or 24-h accumulated urine samples in 94 children (short stature 70, including 14 with complete GH deficiency, 9 with partial GH deficiency, and 47 with GH-normal short stature; Turner's syndrome, 10, and simple obesity, 14). GH values were also determined in the 2nd to 4th urine samples taken on the same day together with the 1st morning urine in 5 of them. GH values in the 1st morning urine correlated significantly with those of the 24-h urine and with serum peak and mean GH values during nocturnal sleep as a physiological GH secretion test. The 2nd to 4th urines had lower GH concentrations than the 1st morning urine. The GH value of the 1st morning urine in complete GH deficiency was significantly lower than those in GH-normal short stature, partial GH deficiency and Turner's syndrome. However, no significant difference was detected in urinary GH values between complete GH deficiency and simple obesity. We conclude that 1st morning urinary GH estimation may be useful for differentiation of complete GH deficiency from other causes of short stature, but may be difficult for the distinction between complete GH deficiency and obesity with normal GH secretory ability.

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