Aim: To determine the usefulness of priming with gonadal steroids prior to GH stimulation with clonidine in the evaluation of the GH status of short children.
Method: 21 males were studied, with a mean chronological age of 13.2±1.5 years (range 1116 years), mean bone age 11.0±1.4 years, Tanner stage 12, with height 135.8±7.4 cm (Ht-SDS −2.8±0.5), and an inadequate response to an initial GH stimulation test with clonidine (peak GH<10 ng/ml). A second stimulation test with clonidine was performed in the same patients after gonadal steroid priming: 50 mg i.m. testosterone propionate daily for 3 days.
Results: 15 of 21 children (71%) increased their GH response to a level of >10 ng/ml following priming with gonadal steroids. Mean peak GH after priming was 11.32±5.6 ng/ml compared to a peak GH level of 3.9±2.8 ng/ml prior to gonadal steroid priming (peak GH 14.45±2.0 ng/ml in the responders vs 6.2±2.4 ng/ml in the non-responders).
Conclusion: Priming with gonadal steroids significantly improves GH secretion following GH stimulation with clonidine and diminishes the possibility of a false diagnosis of GH deficiency.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology