Clinical Audit of Clonidine as a First-Line Provocative Agent to Exclude Growth Hormone Deficiency in Children with Short Stature
https://doi.org/10.15605/jafes.041.S1
- Author:
Mazidah Noordin
1
;
Sook Weih Lew
1
;
Alexis Anand Dass
1
;
Jay Yin Lim
2
;
Noor Shafina Mohd Nor
1
Author Information
1. Department of Paediatrics, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi Mara (UiTM);Department of Paediatrics, Hospital Al-Sultan Abdullah, UiTM Puncak Alam, Universiti Teknologi Mara (UiTM)
2. Department of Paediatrics, Hospital Al-Sultan Abdullah, UiTM Puncak Alam, Universiti Teknologi Mara (UiTM)
- Publication Type:Journal Article
- MeSH:
Child;
Clonidine;
Clinical Audit;
Growth Hormone
- From:
Journal of the ASEAN Federation of Endocrine Societies
2026;41(S1):138-
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Clonidine is frequently utilized as a stimulus of growth
hormone secretion to diagnose growth hormone deficiency
in children. This clinical audit evaluates the efficacy and
safety profile of clonidine as a sensitive, first-line screening
agent to exclude GHD in children.
Methodology:A clinical audit was conducted on seven patients (4 females,
3 males) aged 7.1 to 12.3 years (median age 11.1) evaluated
with clonidine stimulation test. The cohort included
one prepubertal and six post-pubertal (highest tanner 2)
children. Bone age was delayed at BA/CA ratio at 0.63–0.9
(median 0.8). Baseline IGF-1 levels ranged from 56 to 264 ng/mL. None of the children received sex steroid priming.
A peak GH threshold of >10 ng/mL was utilized to exclude
GHD. Safety profiles, specifically hemodynamic stability
and level of consciousness, were actively monitored.
Results:Clonidine effectively stimulated GH secretion and excluded
GHD in six out of seven patients, yielding peak GH levels
between 10.3 and 20.6 ng/mL. One patient with peak GH of
7.6 ng/mL with clonidine, and subsequent test with insulin
tolerance test (ITT), confirmed GHD with a peak GH of 7.4
ng/mL. All participants (n = 7) experienced drowsiness.
Hemodynamic adverse events were notable. Three
patients experienced mild hypotension, and three patients
developed clinically significant hypotension requiring
normal saline fluid bolus.
Conclusion:Clonidine is a highly effective, sensitive first-line screening
agent to exclude GHD, as it reliably stimulates GH peaks
above diagnostic thresholds. However, close supervision
is required due to drowsiness and the potential for
severe hypotension requiring fluid resuscitation. Clinical
judgment remains essential as secondary testing with
another GH secretagogue is warranted when clinical
suspicion persists.
- Full text:2026081009063131519EP_P007.pdf
