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Arginine test is not reliable for diagnosing cerebellar multiple system atrophy
Raquel C Gardner1, Jeremy D Schmahmann
1Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Annals of Neurology
|April 8, 2010
Summary
The arginine growth hormone stimulation test is unreliable for diagnosing cerebellar-type multiple system atrophy (MSAc). Peak serum GH responses showed no significant differences across patient groups and controls.
Area of Science:
- Neurology
- Endocrinology
- Clinical Diagnostics
Background:
- Cerebellar ataxia presents diagnostic challenges.
- Multiple System Atrophy (MSA) with cerebellar onset (MSAc) requires accurate diagnostic tools.
- Growth hormone (GH) stimulation tests are used in endocrine diagnostics.
Purpose of the Study:
- To evaluate the diagnostic utility of the arginine GH stimulation test for MSAc.
- To compare GH responses in MSAc patients, idiopathic late-onset cerebellar ataxia (ILOCA), familial ataxia, and healthy controls.
Main Methods:
- Arginine GH stimulation test administered to 14 MSAc, 11 ILOCA, 10 familial ataxia, and 10 healthy controls.
- Pituitary GH deficiency was excluded prior to testing.
- Peak serum GH levels were measured and analyzed.
Main Results:
- No significant differences in peak GH response were observed between the groups.
- 33% of MSAc patients showed GH responses >10 microg/l.
- 36% of ILOCA and 40% of healthy controls had GH responses <4 microg/l.
Conclusions:
- The arginine GH stimulation test is not a reliable diagnostic marker for MSAc.
- GH response variability limits its use in differentiating MSAc from other ataxias.
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