Clonidine testing is a reliable method for diagnosing growth hormone deficiency (GHD) in children and adolescents and steroid priming may not be needed, according to findings published in Clinical Endocrinology.
Although clonidine testing is widely used to study GH secretion in children, there are limited data on its accuracy for diagnosing GHD. In a retrospective study, the investigators now analyzed the reliability of clonidine testing in the diagnosis of GHD and the effect of puberty on the GH response to clonidine testing in a large cohort of children and adolescents.
Data were collected from 327 children and adolescents with short stature and/or poor growth velocity between 2005 and 2013, and all participants underwent diagnostic procedures for suspected GHD. Clonidine was administered (0.15 mg/m² body surface [square root (height [cm] × weight [kg]/3600)] orally after overnight fasting.
The GH peak after clonidine testing was <7 μg/L in 73 prepubertal children and 25 adolescents, and GHD was confirmed in 87 (37 organic, 50 idiopathic) patients. False-positive results were seen in 6 prepubertal and 5 pubertal patients. The median (interquartile range) peak GH after clonidine testing was similar for both prepubertal and pubertal children with GHD (3.80 μg/L [1.7-6.00] vs 3.51 μg/L [0.76-5.74]) and those without GHD (13.70 μg/L [10.70-18.40] vs 12.40 μg/L [9.90-19.25]).
“The oral [clonidine test] is safe and simple to perform and may be used as the first GH stimulation test in the evaluation of short children with suspected GHD,” wrote the authors.
Ibba A, Guzzetti C, Casula L, et al. Reliability of clonidine testing for the diagnosis of growth hormone deficiency in children and adolescents [published online September 1, 2018]. Clin Endocrinol (Oxf). doi:10.1111/cen.13845