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    GH REPLACEMENT therapy has been offered to GH-deficient children for more than 30 yr, but it only became a licensed indication for GH-deficient adults in the United States, a number of European countries, and New Zealand in 1996. Thus, in contrast to the longstanding pediatric literature and interest in the biochemical diagnosis of GH deficiency (GHD), the concerns of the endocrinologist treating adults have been addressed only recently. The type of underlying pathophysiology differs in childhood-onset compared with adult-onset GHD. In childhood, the commonest etiology is isolated idiopathic GHD (1, 2), a blanket term, which includes some children with distinctive pathophysiology that may be demonstrated radiologically, and others in whom the pathological insult is unknown and the explanation for the GHD ill-understood. In contrast, adult-onset GHD is most frequently due to a pituitary adenoma and/or treatment with surgery or radiotherapy (3, 4); isolated idiopathic GHD acquired in adult life has never been reported. In childhood the differential diagnosis is dominated by alternative causes of poor growth (5–9), whereas difficulties in the diagnosis of adult-onset GHD (10–12) exist in the obese and in the elderly. The purpose of this review is to evaluate the usefulness of a variety of clinical and biochemical approaches to the diagnosis of GHD in children and adults. GH Stimulation Tests - labnet.health.nz buy retin a .1 online Clonidine is a better test for growth hormone deficiency than insulin. Growth Hormone Test - Cincinnati Children's Hospital
     
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