Abstract
To combine a classical test for GH secretion with the assessment of GH pituitary reserve, we evaluated GH secretion in short children by two sequential Arginine(Arg) tests: a first Arg test(Arginine HCL, 0.5 g/kg, infused in 30 min), immediately followed by a combined Arg+GHRH test (1 μg/kg iv bolus of GHRH-(l-24). Peak GH responses were considered normal when ≥7 ng/ml after Arg test and ≥20 ng/ml after Arg+GHRH test. Subjects were 103 children (aged 6-16 years;63 males;77 prepubertal; height <5th centile); 41 with normal growth rate (height velocity SD score >−0.80); 26 with borderline growth rate (HVSDS −0.80 to−2); 35 with slow growth rate (HVSDS <−2). Results, a) Normal responses to both tests were found in 79 (76.7%) subjects (33, 22, 24, in normal, borderline and slow growth groups, respectively); low responses to Arg but normal to Arg+GHRH were found in 22 (21.4%) children (8, 3, 11 in normal, borderline and slow growth groups, respectively); low responses to both test were found in 2 subjects, with borderline and slow growth, b) In 72 children, a Clonidine test(0.15 mg/m2;normal peak >7 ng/ml) showed a 73.3% concordance with the Arg test. c) In 20 children, mean overnight GH secretion was evaluated (MGHC) and a score was assigned to both GH peaks after Arg+GHRH test: a combined score > 10 predicted 91% of MGHC greater than 3 ng/ml. In conclusion, the sequential Arginine-Arginine plus GHRH test is a safe and convenient procedure for an initial characterization of GH secretion and GH pituitary reserve in short children.
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Dammacco, F., Pesce, S., Dammacco, A. et al. ARGININE INFUSION FOLLOWED BY ARGININE PLUS GROWTH HORMONE(GH) RELEASING HORMONE ADMINISTRATION: A TEST TO ASSESS GH SECRETION. Pediatr Res 33 (Suppl 5), S49 (1993). https://doi.org/10.1203/00006450-199305001-00278
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DOI: https://doi.org/10.1203/00006450-199305001-00278