Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) This panel must include the following: Human growth hormone (HGH) (83003 x 4)
CPT4 code
Name of the Procedure:
Growth Hormone Stimulation Panel (e.g., Arginine Infusion, L-Dopa Administration)
Summary
A Growth Hormone Stimulation Panel is a medical test that measures the body's production of human growth hormone (HGH). The procedure involves administering specific substances like arginine or L-dopa to stimulate HGH release, and then taking multiple blood samples to measure HGH levels at different times.
Purpose
The procedure is used to diagnose growth hormone deficiencies in children and adults. The goal is to determine if the body produces sufficient levels of HGH, which is critical for growth and development in children and for maintaining bone density, muscle mass, and metabolism in adults.
Indications
- Short stature in children
- Unexplained fatigue
- Decreased muscle mass
- Poor bone density
- Delayed puberty in children
- Adults with known pituitary disorders
Preparation
- Fast for 8-12 hours prior to the procedure.
- Avoid vigorous exercise the day before the test.
- Medication adjustments may be needed; consult with your healthcare provider.
- Baseline blood tests may be required before the stimulation test.
Procedure Description
- Initial Assessment: Baseline blood sample is taken for HGH measurement.
- Administration of Stimulants: Arginine or L-dopa is administered via infusion or orally.
- Blood Sampling: Blood samples are collected at multiple intervals (e.g., 30, 60, 90, and 120 minutes) after the administration of the stimulant.
- HGH Measurement: Each blood sample is analyzed for HGH levels.
Tools/Equipment:
- Intravenous (IV) infusion setup or oral medication
- Blood draw supplies (needles, syringes, collection tubes)
- Lab equipment for HGH analysis
Anesthesia/Sedation:
- Typically not required as the procedure involves only blood draws.
Duration
The procedure usually takes around 2-3 hours, depending on the intervals of blood sampling.
Setting
The procedure is performed in a hospital or outpatient clinic.
Personnel
- Endocrinologist or Pediatrician
- Nurses or phlebotomists for blood draws
- Laboratory technicians for HGH analysis
Risks and Complications
- Common: Mild discomfort or bruising at the blood draw site.
- Rare: Allergic reactions to the stimulants, low blood sugar, or dizziness.
Management:
- Monitor patient during the procedure and provide appropriate interventions if reactions occur.
Benefits
- Accurate diagnosis of HGH deficiency
- Helps guide treatment decisions
- Improved growth and development in children
- Better management of symptoms in adults
Recovery
- Minimal post-procedure care needed.
- Patients can typically resume normal activities immediately.
- Follow-up consultations to discuss test results and treatment plans.
Alternatives
- IGF-1 blood test: Measures Insulin-like Growth Factor to infer HGH levels.
- MRI of the brain if a pituitary disorder is suspected.
- Pros and cons: Less specific compared to direct stimulation testing, but non-invasive.
Patient Experience
- During: Minor discomfort from multiple blood draws.
- After: Normal activities can be resumed; some might feel fatigued or lightheaded temporarily.
- Pain management: Local application of ice or warm compresses to blood draw sites if discomfort persists.