GH Provocative Test in Diagnosis of GH deficiency in Childhood, Can We Trust on Them?

Abstract

The most common reason for referral a Paediatric patient to the Endocrinologist is short stature. But the diagnosis of growth hormone deficiency (GHD) in childhood is a big challenge, due to the lack of gold standard tests.The GDH can be total (the diagnosis is easy to suspect: pituitary lesions or congenital deficiency) or partial (diagnosis is more complex -cases are not accompanied by any clinic) when it will be necessary to do GH provocative tests.Thus most common provocative tests of GH release (insulin tolerance test (hypoglycaemia), L-dopa, arginine, glucagon, propranolol, clonidine and GHRH) are used to determine GH status. But, for the definitive diagnosis not only will be necessary the provocative test results, it Will always be necessary to take into consideration also the clinical criteria together with auxological and biochemical parameters. Conclusion:It would be advisable to use provocative tests of GH release with the highest percentages of sensitivity and specificity to detect subjects with GHD (insulin tolerance test "gold standar") but always excluding patients with an adequate GH response before.