Pegvisomant-primed growth hormone (GH) stimulation test is useful in identifying true GH deficient children

Radetti, Giorgio; Elsedfy, Heba; Khalaf, Randa I.; Meazza, Cristina; Pagani, Sara; Kholy, Mohamed El; Albertini, Riccardo; Stefano, Anna Maria De; Navarra, A.; Silvestri, Annalisa De; Bozzola, Mauro

doi:10.1007/bf03401523

Cited by 2 publications

(4 citation statements)

References 13 publications

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“…A possible solution to these problems may be introduction of new diagnostic tests, such as the assessment of GH secretion in stimulation tests after priming with pegvisomant. It has been shown that GH peaks in this test correlated with IGF-1 levels [25]. Unfortunately, this study was performed on a relatively small group of children, and thus requires further validation.…”

Section: Discrepancies Between Igf-1 Levels and The Results Of Gh Stimulation Testsmentioning

confidence: 91%

“…Next year, Radetti et al [25] proposed using pegvisomant as a new type of primer to enhance GH secretion, enabling to decrease the rate of false positive results of GH stimulation tests in children. As the study was performed on a relatively small group of patients, its promising results seem to require further validation.…”

Section: Disregarding Factors Influencing Gh Secretion In Interpreting the Results Of Stimulation Testsmentioning

confidence: 99%

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Inclusion and Withdrawal Criteria for Growth Hormone (GH) Therapy in Children with Idiopathic GH Deficiency—Towards Following the Evidence but Still with Unresolved Problems

Smyczyńska

2022

Endocrines

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According to current guidelines, growth hormone (GH) therapy is strongly recommended in children and adolescents with GH deficiency (GHD) in order to accelerate growth rate and attain normal adult height. The diagnosis of GHD requires demonstration of decreased GH secretion in stimulation tests, below the established threshold value. Currently, GHD in children is classified as secondary insulin-like growth factor-1 (IGF-1) deficiency. Most children diagnosed with isolated GHD present with normal GH secretion at the attainment of near-final height or even in mid-puberty. The most important clinical problems, related to the diagnosis of isolated GHD in children and to optimal duration of rhGH therapy include: arbitrary definition of subnormal GH peak in stimulation tests, disregarding factors influencing GH secretion, insufficient diagnostic accuracy and poor reproducibility of GH stimulation tests, discrepancies between spontaneous and stimulated GH secretion, clinical entity of neurosecretory dysfunction, discrepancies between IGF-1 concentrations and results of GH stimulation tests, significance of IGF-1 deficiency for the diagnosis of GHD, and a need for validation IGF-1 reference ranges. Many of these issues have remained unresolved for 25 years or even longer. It seems that finding solutions to them should optimize diagnostics and therapy of children with short stature.

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Section: Discrepancies Between Igf-1 Levels and The Results Of Gh Stimulation Testsmentioning

confidence: 91%

Section: Disregarding Factors Influencing Gh Secretion In Interpreting the Results Of Stimulation Testsmentioning

confidence: 99%

Inclusion and Withdrawal Criteria for Growth Hormone (GH) Therapy in Children with Idiopathic GH Deficiency—Towards Following the Evidence but Still with Unresolved Problems

Smyczyńska

2022

Endocrines

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“…131,132 A provocative test is also used to diagnose growth hormone deficiency, usually by assessing insulin tolerance or glucagon stimulation. 133,134 The list of chronic diseases of the internal organs diagnosed with a provocative test at the preclinical stage can be significantly expanded.…”

Section: Provocative Test As An Approach To the Early Diagnosis Of mentioning

confidence: 99%

“…Successful preclinical trials of a provocative test with αMpT 136 have opened up prospects for conducting clinical trials. It should be F I G U R E 2 Implementation of a provocative test for the early (preclinical) diagnosis of Parkinson's disease (PD), using α-methyl-ptyrosine (αMpT), a nonmetabolizable reversible inhibitor of tyrosine hydroxylase and, hence, dopamine (DA) synthesis (modified from 134 ). A, Schematic hypothetical representation of the depletion of striatal DA using αMpT in patients at the preclinical stage of PD to a threshold level at which motor disorders first appear; B, αMpT-induced dose-dependent depletion of DA in the striatum in normal mice 4 h after a single injection of αMpT.…”

Section: Prospects and Risks Of Using αMpt As A Provocative Testmentioning

confidence: 99%

Development of early diagnosis of Parkinson's disease: Illusion or reality?

Ugrumov

2020

CNS Neurosci Ther

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The fight against neurodegenerative diseases, Alzheimer disease and Parkinson's disease (PD), is a challenge of the 21st century. The low efficacy of treating patients is due to the late diagnosis and start of therapy, after the degeneration of most specific neurons and depletion of neuroplasticity. It is believed that the development of early diagnosis (ED) and preventive treatment will delay the onset of specific symptoms. This review evaluates methodologies for developing ED of PD. Since PD is a systemic disease, and the degeneration of certain neurons precedes that of nigrostriatal dopaminergic neurons that control motor function, the current methodology is based on searching biomarkers, such as premotor symptoms and changes in body fluids (BF) in patients. However, all attempts to develop ED were unsuccessful. Therefore, it is proposed to enhance the current methodology by (i) selecting among biomarkers found in BF in patients at the clinical stage those that are characteristics of animal models of the preclinical stage, (ii) searching biomarkers in BF in subjects at the prodromal stage, selected by detecting premotor symptoms and failure of the nigrostriatal dopaminergic system. Moreover, a new methodology was proposed for the development of ED of PD using a provocative test, which is successfully used in internal medicine.

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Pegvisomant-primed growth hormone (GH) stimulation test is useful in identifying true GH deficient children

Cited by 2 publications

References 13 publications

Inclusion and Withdrawal Criteria for Growth Hormone (GH) Therapy in Children with Idiopathic GH Deficiency—Towards Following the Evidence but Still with Unresolved Problems

Inclusion and Withdrawal Criteria for Growth Hormone (GH) Therapy in Children with Idiopathic GH Deficiency—Towards Following the Evidence but Still with Unresolved Problems

Development of early diagnosis of Parkinson's disease: Illusion or reality?

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