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Identifying growth hormone deficiency (GHD) can be a diagnostic challenge. In clinical practice, it can be difficult to differentiate among GHD, idiopathic short stature or constitutional delay of growth and puberty. A combination of auxological data, insulin-like growth factor 1 activity, neuroimaging and detailed clinical history is used alongside growth hormone stimulation tests (GHSTs).
There is variation in UK practice on how children are tested for GHD.1 GH treatment is expensive as well as burdensome to the patient.
It is well known that sex steroids augment the GH response …