Thursday, July 4, 2019

Reference values Modification

Test code: 4590; 4591; 4592; 4593; 4594; 4595; 4596; 4597; 4598; 5421; 5472; 7492; 7493; 8115

Effective update from 08/07/2019

Reference values modification in the following tests:
4590 - STIMULATION OF GROWTH HORMONE HGH (30'), SERUM
4591 - STIMULATION OF GROWTH HORMONE HGH (60'), SERUM
4592 - STIMULATION OF GROWTH HORMONE HGH (90'), SERUM
4593 - STIMULATION OF GROWTH HORMONE HGH (120'), SERUM
4594 - STIMULATION OF GROWTH HORMONE HGH (180'), SERUM
4595 - STIMULATION OF GROWTH HORMONE HGH (240'), SERUM
4596 - STIMULATION OF GROWTH HORMONE HGH (10'), SERUM
4597 - STIMULATION OF GROWTH HORMONE HGH (20'), SERUM
4598 - STIMULATION OF GROWTH HORMONE HGH (300'), SERUM
5421 - STIMULATION OF GROWTH HORMONE HGH (45'), SERUM
5472 - STIMULATION OF GROWTH HORMONE HGH (150'), SERUM
7492 - STIMULATION OF GROWTH HORMONE HGH (15'), SERUM
7493 - STIMULATION OF GROWTH HORMONE HGH (-15'), SERUM
8115 - STIMULATION OF GROWTH HORMONE HGH (210'), SERUM



PREVIOUS

  
          Baseline:
          MEN  :  Less than  3 ng/mL
          WOMEN:  Less than  8 ng/mL
          Functional test:
          GRF, Exercise, Exercise + Propranolol, Exercise + L-DOPA, L-DOPA, Clonidine,Arginine or Insulin:
          In all tests, must be obtained a difference between the maximum and baseline at least of 4.6 
          ng/mL.
      
  
NEW

Insulinic hypoglycaemia test (ITT)

      0.10 U/kg rapid insulin intravenous administration
0.05-0.075 U/kg if ACTH deficiency is suspected                  
0.15-0.20  U/kg in acromegalic and obese patients.

Adults normal respone: poststimulation GH concentration greater or equal than 5 ng/mL.
Children normal response: poststimulation GH concentration above 7.4 ng/mL.


Stimulation test with glucagon

Adults: 1 mg intramuscular glucagon.
In children under 30 kg, 0.03 mg/kg of body weight.

Adults: The cut-off point for GH deficiency diagnosis (between 60 and 120 minutes) is a GH peak value of 3 ng/mL.
Children: partial GH deficency is considered when GH peak value is between 3.3 and 6.7 ng/mL and an abnormal response when peak value is  <3.3 ng/mL.

Clonidine test

Administer the corresponding dose of clonidine orally (commercialized as CATAPRESAN ®, each tablet contains 0.150 mg).
In children younger than 10 years old, 0.075 mg/m2 of body surface area and, older than 10 years old, 0.10 mg/m2 (maximum one tablet).

Children normal response: poststimulation GH concentration greater or equal than 7.4 ng/mL.


Exercise test

Patient must perform a regular and intense exercise for 20 minutes.

Children normal response: poststimulation GH concentration greater or equal than 7.4 ng/mL.

Oral glucose overload test
  
Administration of 75 grams of glucose.

In normal subjects, GH concentration is suppressed at undetectable values <0.2 ng/mL, while in patients with acromegaly it stays above 0.4 ng/mL

Stimulation with hormone releasing growth hormone and arginine

BMI and age strongly influence the cut-off point of the subject evaluated. Stimulation response significantly decreases when age and BMI increases.

Source: Functional test guides in the clinical laboratory. SEQC (Guías de pruebas funcionales en el laboratorio clínico, Spanish Society of Clinical Biochemistry and Molecular Pathology) 2014




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