Testing for growth hormone deficiency in children

Richmond, Erick; Rogol, Alan D.

doi:10.1016/j.ghir.2019.12.002

Cited by 6 publications

(9 citation statements)

References 26 publications

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“…Growth hormone stimulation testing is the accepted standard of care for the evaluation of GHD in the pediatric population, and these tests are considered safe with appropriate monitoring [13]. In this report, we describe a rare combination of myalgia and gross painless hematuria that were related to the use of clonidine and arginine for GH stimulation testing.…”

Section: Discussionmentioning

confidence: 93%

“…ere are also published cases of lower limb myalgia following clonidine administration in the context of opioid withdrawal management in adults [24]. One possible mechanism by which clonidine may cause myalgia may be related to the acute onset of hypotension and bradycardia from its alpha-agonistic effects [13,21], with reduced perfusion and transient ischemia of the calf muscles. It has been suggested that the use of the oral hydration therapy is one potential intervention to prevent hypotension with the test [25].…”

Section: Discussionmentioning

confidence: 99%

“…To enhance the accuracy of diagnosing GHD, it is accepted that responses to two GH stimulation tests are used to make the diagnosis [10,11], and two of the commonly used agents in testing include clonidine and arginine [6]. ese medications are generally accepted as being safe [12,13].…”

Section: Introductionmentioning

confidence: 99%

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Myalgia and Hematuria in Association with Clonidine and Arginine Administration for Growth Hormone Stimulation Tests

Glibbery

Fleming

Chanchlani

et al. 2020

Case Reports in Medicine

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Growth hormone deficiency (GHD) in children has significant impacts on growth and metabolism. Two-agent GH stimulation tests are commonly used to diagnose GHD, and these tests are generally considered safe. We report the case of a 5-year 5-month-old boy with a history of anaplastic ependymoma who underwent GH stimulation testing for growth deceleration using clonidine and arginine. He developed bilateral calf myalgia and gross hematuria within 24 hours of the tests. Myalgia and hematuria resolved spontaneously. Importantly, the literature review and database searches for hematuria identified 6 cases with clonidine and 20 cases with arginine. This case highlights an unusual combination of adverse reactions to clonidine and arginine in children undergoing GH stimulation testing to assess for GHD. Pediatric endocrinologists need to be aware of the potential for these side effects to allow appropriate management, and further studies are needed to clarify the mechanisms and frequency of these side effects. We recommend that patients and families need to be counselled about hematuria as an association of GH testing with these medications.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Myalgia and Hematuria in Association with Clonidine and Arginine Administration for Growth Hormone Stimulation Tests

Glibbery

Fleming

Chanchlani

et al. 2020

Case Reports in Medicine

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“…Growth hormone deficiency (GHD) in children is associated with abnormal linear growth, manifesting as short stature and reduced age-related height velocity (HV) [ 1 ]. GHD is also associated with metabolic alterations, resulting in dyslipidemia and insulin resistance as well as an increased risk of cardiovascular disease [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Once-Weekly Somatrogon Compared with Once-Daily Somatropin (Genotropin®) in Japanese Children with Pediatric Growth Hormone Deficiency: Results from a Randomized Phase 3 Study

et al. 2022

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Introduction Somatrogon is a long-acting recombinant human growth hormone being developed as a once weekly treatment for children with growth hormone deficiency (GHD). The objective of this Phase 3 study (NCT03874013) was to compare the efficacy and safety of once-weekly somatrogon with once-daily Genotropin in Japanese children with GHD. Methods In this open-label, randomized, active-controlled study, 44 prepubertal Japanese children with GHD (boys: 3 to <11 years; girls: 3 to <10 years) were randomized 1:1 to receive once weekly somatrogon or once daily Genotropin (0.025 mg/kg/day) for 12 months. Dose escalation for somatrogon-treated subjects occurred in the first 6 weeks (0.25, 0.48, and 0.66 mg/kg/week; 2 weeks each) with the remaining 46 weeks at a dose of 0.66 mg/kg/week. The study’s primary endpoint was annualized height velocity (HV) at 12 months. Results Baseline characteristics were similar between treatment groups. Compared with Genotropin-treated subjects, somatrogon-treated subjects had higher least-squares (LS) mean HV at 12 months (9.65 cm/year vs 7.87 cm/year). Once weekly somatrogon was concluded as being comparable to once daily Genotropin as the mean treatment difference (somatrogon-Genotropin) in HV was +1.79 cm/year (95% CI, 0.97–2.60), which was greater than the pre-established margin (–1.8 cm/year). For both treatment groups, most adverse events were mild to moderate in severity and a similar proportion of subjects reported injection-site pain, although the somatrogon group reported more painful injections. Conclusion In prepubertal Japanese children with GHD, once-weekly somatrogon was comparable to once-daily Genotropin in terms of annualized (12-month) HV. Both treatments had similar safety and tolerability profiles. ClinicalTrials.gov:NCT03874013

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“…In about half of the children with GHD, the cause is unknown (idiopathic GHD). [1][2][3] Treatment with GH is in large effective in advancing final height. 4 Besides promoting growth, GH also has substantial metabolic effects.…”

Section: Introductionmentioning

confidence: 99%

Psychiatric Disorders and Peer-Victimization in Children and Adolescents With Growth Hormone Deficiency

Çoban

Bedel

Önder

et al. 2022

Clin Pediatr (Phila)

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In this study, we aimed to investigate psychiatric disorders, bullying/victimization, and quality of life in children and adolescents with idiopathic growth hormone deficiency (GHD). Sixty-one children and adolescents who were diagnosed as having idiopathic GHD were evaluated using a semistructured interview by a child and adolescent psychiatrist. Some 45.9% of the subjects with GHD were diagnosed with at least 1 psychiatric disorder. The most common psychiatric diagnosis was social anxiety disorder (18.3%). Twenty-eight percent of the subjects reported being bullied by their peers. Victimization rates were less frequent in those treated for more than 1 year. Children aged between 6 and 12 years had poorer quality of life and higher anxiety levels than adolescents aged between 13 and 18 years. Due to the higher rates of existing psychiatric disorders, the clinical management of patients with GHD should be conducted with a multidisciplinary approach, in which pediatric endocrinologists and mental health professionals work in coordination.

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Testing for growth hormone deficiency in children

Cited by 6 publications

References 26 publications

Myalgia and Hematuria in Association with Clonidine and Arginine Administration for Growth Hormone Stimulation Tests

Myalgia and Hematuria in Association with Clonidine and Arginine Administration for Growth Hormone Stimulation Tests

Efficacy and Safety of Once-Weekly Somatrogon Compared with Once-Daily Somatropin (Genotropin®) in Japanese Children with Pediatric Growth Hormone Deficiency: Results from a Randomized Phase 3 Study

Psychiatric Disorders and Peer-Victimization in Children and Adolescents With Growth Hormone Deficiency

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