Sex steroid priming in short stature children unresponsive to GH stimulation tests: Why, who, when and how.
GH deficiency (GHD)
growth hormone stimulation test (GHST)
peripubertal age
pubertal delay
sex steroid priming
short stature
Journal
Frontiers in endocrinology
ISSN: 1664-2392
Titre abrégé: Front Endocrinol (Lausanne)
Pays: Switzerland
ID NLM: 101555782
Informations de publication
Date de publication:
2022
2022
Historique:
received:
17
10
2022
accepted:
14
11
2022
entrez:
16
12
2022
pubmed:
17
12
2022
medline:
20
12
2022
Statut:
epublish
Résumé
Despite decades of experience, the diagnosis of growth hormone deficiency (GHD) remains challenging, especially in peripubertal children. Failure to respond to GH stimulation tests (GHSTs) is needed to confirm GHD, but long-standing controversies regarding the number of tests needed and the interpretation of GH peaks are still a matter of debate worldwide. Diagnostic workup is even more problematic in short children with slow growth and delayed sexual development: they often exhibit low GH peaks under GHST, which often normalize as puberty progresses. Consequently, this transient suboptimal response to GHST may result in GH overtreatment, carrying both health and economic concerns. Considering the complex and bound link between GH axis and sex steroids, the use of sex steroid priming prior to GHST might be helpful in peripubertal setting. However, its use is still controversial. There is no consensus regarding patient selection, timing, dose, and preparation of sex steroids. In this review, we aim to overview the use of sex steroid priming in clinical practice, highlighting the need to develop appropriate guidelines in order to overcome diagnostic pitfalls in peripubertal age.
Identifiants
pubmed: 36523598
doi: 10.3389/fendo.2022.1072271
pmc: PMC9744763
doi:
Substances chimiques
Human Growth Hormone
12629-01-5
Gonadal Steroid Hormones
0
Steroids
0
Types de publication
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1072271Informations de copyright
Copyright © 2022 Partenope, Galazzi, Albanese, Bellone, Rabbone and Persani.
Déclaration de conflit d'intérêts
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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