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Growth hormone deficiency — SCE Endocrinology MCQ

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HardPituitaryGrowth hormone deficiencySCE Endocrinology

A 17-year-old with short stature and delayed puberty undergoes a valid insulin tolerance test. Glucose falls to 2.0 mmol/L, peak GH is 2 micrograms/L and peak cortisol is 650 nmol/L. Which isolated pituitary deficit is demonstrated?

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Correct answer: D — Growth hormone deficiency

Adequate hypoglycaemia was achieved. The robust cortisol peak argues against ACTH deficiency, whereas the very low stimulated GH peak supports growth hormone deficiency in the appropriate clinical setting. Assay-specific cut-offs and pubertal priming policy should be considered by a paediatric endocrine service.

Reference: Clinical practice guideline for adult growth hormone deficiency (Published 2011): https://academic.oup.com/jcem/article/96/6/1587/2833853; Consensus guideline for adult growth hormone deficiency and transition testing (Published 2007): https://academic.oup.com/ejendo/article-abstract/157/6/695/6695917