Rational use of the laboratory for childhood and adult HGH human growth hormone deficiency.
Pandian R - Clin Lab Med - 01-MAR-2004; 24(1): 141-74
From NIH/NLM MEDLINE
NLM Citation ID:
15157561 (PubMed)
Full Source Title:
Clinics in Laboratory Medicine
Publication Type:
Journal Article; Review; Review, Tutorial
Language:
English
Author Affiliation:
Quest Diagnostics Nichols Institute, San Juan Capistrano, CA 92690, USA. Raj.m.Pandian@questdiagnostics.com
Authors:
Pandian R; Nakamoto JM
Number of References:
89
Abstract:
No laboratory test has sufficient diagnostic sensitivity and specificity to serve as a gold standard for the diagnosis for HGHD: therefore, test results must be interpreted after assessment of risk for HGHD is determined on clinical grounds. Growth data are particularly crucial for diagnosis of childhood HGHD; history of known pituitary damage and presence or absence of other pituitary hormone deficiencies are the critical elements for the diagnosis of adult HGHD. New reference preparations are available for HGH and IGF-I and should greatly aid interassay comparisons when the preparations are universally adopted. HGH stimulation testing remains a key part of the diagnosis of adult GHD, but is currently being de-emphasized for the diagnosis of pediatric GHD. Better interassay comparative data and organized clinical collaboration between clinicians and test manufacturers/laboratories to set rational clinical diagnostic cutoffs would improve greatly the clinical usefulness of HGH stimulation testing. The availability of statistically sound age- and sex-related normative data for IGF-I and IGFBP3 make these key tests for the diagnosis of childhood GHD. Although IGF-I may not be a perfect test for the diagnosis of adult GHD, it may be sufficiently informative in many cases to warrant using it on a routine basis. IGF-I also has a role in monitoring the safety of adult patients who are on HGH treatment; studies are underway to determine if IGF-I may be useful in the future for optimization of HGH dosaging.
Major Subjects:
- Chemistry, Clinical / * methods / standards
- Dwarfism, Pituitary / * diagnosis
- Human Growth Hormone / * deficiency
- Pituitary Diseases / * diagnosis
Additional Subjects:
- Adult
- Child
- Humans
Chemical Compound Name:
12629-01-5(Human Growth Hormone)