ESPE Abstracts (2016) 86 P-P2-679

Association between Growth Hormone Peak at a Stimulation Test and Pituitary Morphological Findings in Children with Growth Hormone Deficiency

Maria Cláudia Schmitt-Lobe, Lais Dadan Perini & Leticia Salm


Pediatric Endocrinology Ambulatory, Regional University of Blumenau, Blumenau, Santa Catarina, Brazil


Background: GH deficiency (GHD) diagnosis includes clinical manifestations, laboratory tests and imaging. There are controversies about the validity of the GH stimulation test. A variety of stimulation tests are used in clinical practice. The biochemical definition of GHD has generally been considered to be a peak stimulated GH concentration <10 ng/ml.

Objective: The aim of this study was to check if there is a statistically significant relation between GH peak in growth hormone stimulation test and pituitary morphological findings in children with GHD, assessing whether there is difference between GH peak in patients with and without pituitary morphological abnormalities.

Method: The study was conducted in the Pediatric Endocrinology Ambulatory. The tests were analyzed in 189 patients with GHD. It was analyzed the GH peak in growth hormone stimulation test with clonidine and hypoglycemia and correlate with the presence, or not, of pituitary morphological abnormalities (magnetic resonance imaging and/or computed tomography).

Results: GH clonidine stimulation test with was conducted in 139 patients and nine patients with GH insulin stimulation test. Thirty-seven patients that realized the test with clonidine had pituitary morphological abnormalities; 26 patients of them were males (70.3%). The peak of GH was higher after 60 min of the stimulus (83 patients) (9.21 ng/ml). There is not a statistic difference between the peak of GH in patients with and without pituitary morphological changes, 8.52 and 9.5 ng/ml, respectively. Comparing H-SDS and chronological age at diagnosis in patients with and without morphological pituitary abnormalities they showed no significant difference.

Conclusion: There were more morphological pituitary abnormalities in males with GHD. There is not significant difference between GH peak in patients with and without morphological pituitary abnormalities. The presence of morphological pituitary abnormalities may indicate more severe deficiency, therefore it is necessary more discussions about the validity of the GH stimulation tests.

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