GROWTH-HORMONE SECRETION ASSESSMENT IN THE DIAGNOSIS OF SHORT STATURE

Growth hormone (GH) secretion assessment in the diagnosis of short sta ture presents certain problems in relation to the protocols designed f or it and the interpretation of results, GH measurement in serum may b e accompanied by IGF-I and IGFBP-3 measurements, and in some patients by GHBP measurement, Protocols for evaluating GH response to acute sti muli or spontaneous secretion are tedious, sometimes hazardous and dif ficult to interpret, This is due to the wide variation in responses ob served in normally-growing children, to the age-dependent changes in t hese parameters and, in the case of GH, to the wide variation in immun oassay results, New techniques able to measure biologically-active GH molecules circulating in blood may help to simplify diagnosis, Severe idiopathic or organic GH deficiency poses no diagnostic problems, GH s ecretory insufficiency may be diagnosed as partial, idiopathic, isolat ed GH deficiency or as neurosecretory dysfunction, Clear cut-off value s for these diagnoses and the possibility of a transient reversible pa thology are not well established, Analysis of large series of children with different diagnoses in whom the growth pattern, either spontaneo us or under rhGH treatment, final height and GH secretion re-evaluatio n at the end of growth were studied will help to clarify GH secretion or action abnormalities in these patients.