Diagnosing classic, severe growth hormone deficiency (GHD) in children and adults
is not difficult. In contrast, distinguishing less severe GHD from the GH sufficient
state can be a tremendous challenge, with no sharp dividing line and no gold standard
test by which to evaluate one's diagnostic performance. Clinical laboratory testing
that is integrated carefully with clinical and radiologic data can help to narrow
the range of diagnostic uncertainty but only if one understands the capabilities and
the limitations of the tests that are used in the evaluation and management of suspected
GHD.
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