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Title: Transdermal estradiol priming during clonidine stimulation test in non-growth hormone deficient children with short stature: A pilot study
Authors: Borghi, MMS
Longui, C. A.
Calliari, L. E.
Faria, CDC
Kochi, C.
Monte, O.
Universidade Federal de São Paulo (UNIFESP)
Keywords: growth hormone deficiency
clonidine test
transdermal estradiol
short stature
Issue Date: 1-Mar-2006
Publisher: Freund Publishing House Ltd
Citation: Journal Of Pediatric Endocrinology & Metabolism. Tel Aviv: Freund Publishing House Ltd, v. 19, n. 3, p. 223-227, 2006.
Abstract: The diagnosis of growth hormone (GH) deficiency is strongly influenced by age, body mass index and presence of gonadal steroids. Priming with oral estradiol (E-2) is one possible way to overcome the impact of variable levels of sex steroids. We describe the effects of transdermal estradiol (E-2-t) priming on GH response after clonidine stimulation. in prepubertal children with familial short stature (group 1, n = 12) or constitutional growth delay (group 2, n = 22). All patients underwent A clonidine test (0.1 mg/m(2), p.o.) followed by a clonidine plus E-2-t test (50 mu g/day) with a 7-day interval. Before E-2-t, basal GH and insulin-like growth factor-I (IGF-I) values were similar in the two groups. After E-2-t priming, basal GH was significantly higher only in group 2. When compared with group 1, patients from group 2 had a significant increase of GH peak response when submitted to E-2-t. The number of patients in both groups with adequate GH peak response was higher after E-2-t priming. We conclude that E-2-t priming is able to increase GH peak response after clonidine stimulation and also improves the accuracy of the clonidine test in the diagnosis of GH deficiency. Compared to oral administration, E-2-t delivery can prevent liver toxicity, providing a more physiological mechanism of GH secretion.
ISSN: 0334-018X
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