Recent progress in the understanding of growth disorders has further emphasized that growth hormone deficiency is only one of many causes for growth failure and that growth hormone deficiency (GHD) is over-diagnosed in children with short stature. Over-diagnosis of GHD is problematic as it incorrectly labels children with pituitary disease, leads to overtreatment and misinformation of patients and families, and may sometimes prevent doctors from making the correct diagnosis. Methods that can improve the specificity of GH testing are therefore urgently needed. Estrogen priming of prepubertal children is safe and inexpensive. Available data suggest that it increases specificity and therefore improves testing performance. In this presentation, I will discuss estrogen priming and argue that it should be used if the purpose of testing is to accurately determine whether the child is GH deficient.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology