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Lab Manual for Moffitt-Long and Mount Zion

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Growth Hormone, Pediatric

Item Value
Approval req'd? Yes, contact Chemistry/Immunology Resident at 415-353-1438. for patients > 20 years old.
Available Stat? No
Test code PGHB
Test group GH
Performed by Esoterix
Sendout? Yes
Method RIA, Double antibody
Container type Gold top, Red top
Amount to Collect 2 mL blood
Sample type Serum
Preferred volume 1 mL serum
Min. Volume 0.4 mL serum
Processing notes Separate serum within 1 hour after collection. Freeze at -20C. Ship frozen
Units ng/mL
Normal range
Age
1-2 days 5-53 ng/mL
2-7 days 5-27 ng/mL
31 days-11 months 2-10 ng/mL
Post-overnight fast
Children 0-6 ng/mL
≥ 18 year olds 0-6 ng/mL
Synonyms GH; GH, pediatric; Growth Hormone ultrasensitive
Turn around times Test performed Monday-Saturday. Turnaround time: 2-4 days
Additional information This send-out assay is primarily reserved for testing in pediatric patients with suspected or complex endocrine abnormalities. For adult patients see "Growth Hormone" (test code GH). It requires approval if ordered in patients over the age of 20

Reasons for testing (children and adults):

The assessment of GH secretory capacity is complicated because of the episodic nature of GH release from the pituitary. Basal GH levels can exhibit considerable variability throughout a 24 hour period, thus limiting their clinical utility. Alternatively, measurement of GH response to various stimuli has commonly been used to improve the diagnostic assessment of GH secretion. GH response to provocative stimuli among normal individuals, however is highly variable. Response values greater than 10 ng/mL have historically been considered to reflect normal GH secretory function, while values below 10 ng/mL have been considered to some degree of GH deficiency. However, it should be noted that this limit is arbitrarily derived. A significant percentage of normal controls exhibit response values well below this 10 ng/mL limit. The clinical research literature should be consulted for a more recent detailed review of the interpretation of GH response data.

Because of wide fluctuations in normal levels, normal ranges are difficult to define and measuring random GH values is not usually diagnostically helpful. Screening tests for GH deficiency include measurements 1 hour after sleep or after 20 min of vigorous exercise, but definitive testing requires provocative testing. Increased levels are expected with insulin-induced hypoglycemia, arginine infusion, or the administration of L-dopa or clonidine. Well defined, normative values for stimulation testing are not available for this assay or other widely used growth hormone assays.

Consensus guidelines for the diagnosis and treatment of growth hormone (GH) deficiency in childhood and adolescence: summary statement of the GH Research Society. GH Research Society. J Clin Endocrinol Metab. 2000 Nov;85(11):3990-3
CPT coding 83003-90
LOINC code 2963-7
Last Updated 9/18/2012 2:26:49 PM
Entry Number 1031

If you have additional questions regarding this test, please call: 415-353-1667

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