Growth Hormone Stimulation Test

Growth Hormone Stimulation Test Using Intramuscular Glucagon And Oral Clonidine

• Stimulation is a diagnostic procedure, not a therapeutic one, aimed at assessing the growth hormone reserve in the pituitary gland, which varies from one child to another.
• This test is performed in cases of short stature in children to determine whether there is a deficiency in growth hormone secretion from the pituitary gland, which is the most essential hormone for bone growth in children.
• Growth hormone is secreted by the pituitary gland in a pulsatile or wave-like pattern, which means its peak levels cannot be accurately measured through random blood tests.
• Therefore, we rely on stimulating the release of stored growth hormone in the children.
• We are using 2 medications most of the time:
  • Intramuscular glucagon, which is safe medication. it is also used in children with type 1 diabetes during episodes of hypoglycemia, to keep blood glucose with in acceptable rang and dose calculated according to body weight.
  • The second medication is oral Clonidine, which is also considered safe and has multiple pediatric uses, including for sleep disorder and hyperactivity.

Pre-Test Instructions

• Insurance approval for the growth hormone stimulation test must be followed up by the parents including approval for seven blood draws.
• After obtaining the necessary approvals, the parents must visit the nursing department to verify the approvals and register the child's name in the hormone stimulation scheduling log. The head nurse must be notified so that the stimulation room can be prepared, along with the assignment of an experienced nurse for the procedure.
• Nurses for pediatric department will contact one of the parents to confirm the scheduled test date, also confirming the childs fasting status and water permitted:
  • At least 6 hours of fasting for children under 6 years.
  • At least 8 hours of fasting for children 6 years of age.
  • Parental consent for the stimulation must be obtain.
  • The child must be fasting from food only for 6 to 8 hours, depending on their age and is allowed to drink only water.
  • After administering the medications, blood samples for growth hormone levels are drawn every 30 minutes for a total duration of three and a half hours.
  • Blood glucose test are checked and vital signs are monitored every 30 minutes by an experienced nurse under the supervision of the attending physician.
  • An intravenous line is inserted for the child throughout the stimulation period and adjusted according to weight to prevent low blood pressure.
  • If there are any questions or concerns, please consult the attending physician.