Somatostatin infusion withdrawal in the diagnosis of childhood growth hormone deficiency

• Published in: Pediatrics international 2003-10, Vol.45 (5), p.538-542
• Main Authors: Bosnak, Mehmet, Dikici, Bunyamin, Haspolat, Kenan, Dogru, Omer, Ozkan, Ilker, Ece, Aydin
• Format: Article
• Language: English
• Subjects: Case-Control Studies; Child; Female; growth hormone deficiency; Human Growth Hormone - administration & dosage; Human Growth Hormone - blood; Human Growth Hormone - deficiency; Humans; Infusion Pumps; Male; somatostatin; stimulation test; Time Factors
• ISSN: 1328-8067; 1442-200X
• DOI: 10.1046/j.1442-200X.2003.01774.x

Objective : An evaluation of growth hormone (GH) testing for GH deficiency (GHD) in childhood is confounded by the lack of a world‐wide consensus on the definition of GHD. Although a single GH test remains the most powerful biochemical tool in the evaluation of a child with growth failure, the test remains far from ideal. Withdrawal of somatostatin (SS) infusion is followed by a rebound rise of GH thought to be mediated by endogenous GH‐releasing hormone (GHRH) function. This study was designed to compare the GH response to 90 min SS infusion in children with normal GH secretion versus children with GH deficiency. Methods : Ten children with GHD and 10 healthy controls (NC) have been evaluated for GH response to somatostatin infusion withdrawal (SSIW) and compared with response of two provocative tests, glucagon plus propranolol test and L‐Dopa test. All children received constant infusion of somatostatin for 90 min (3 µg/kg per h, Stilamin, Serono, Aubonne, Switzerland). In order to determine GH, blood samples were obtained 90 min before the SS infusion and 0, 15, 30, 45, 60, 75, and 90 min after the cessation of infusion. Results : Growth hormone peak levels with SSIW were significantly lower in GH deficient children than in healthy children (2.5 ± 1.2 ng/dL, vs 21.9 ± 5.3 ng/dL, respectively, P