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Appendix 2 - Dynamic tests

Published online by Cambridge University Press:  15 February 2010

Amanda Ogilvy-Stuart
Affiliation:
University of Cambridge
Paula Midgley
Affiliation:
University of Edinburgh
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Summary

In the neonate dynamic testing should not be undertaken without suitable indwelling lines, and under the advice of a paediatric endocrinologist. For pituitary function testing, or corticotrophin-releasing hormone (CRH) test, this means an arterial line for sampling. A short Synacthen test can usually be performed without an arterial line.

Anterior pituitary function tests

  • Measurement of random free thyroxine (fT4) and thyroid-stimulating hormone (TSH, after the initial postnatal surge in the first 2 days of life) provides information about pituitary and thyroid function.

  • Baseline gonadotrophin levels (leuteinizing hormone, LH; follicle stimulation hormone, FSH) can also be informative, as they should be relatively high in the newborn period.

  • Measurement of cortisol and growth hormone (GH) at the time of hypoglycaemia can be helpful, but, unlike older infants and children, the normal neonate may produce a good GH response to hypoglycaemia, but a poor cortisol response.

  • Measurement of several (at least 3) random cortisol levels is useful, as cortisol is released in a pulsatile manner and may be low (e.g. 50 nmol/L) in normal infants if measured at the nadir. Timing is not important as diurnal variation does not appear for 8–12 weeks. All samples could be on the same day (and therefore the results could be reported together).

  • […]

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Publisher: Cambridge University Press
Print publication year: 2006

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  • Dynamic tests
  • Amanda Ogilvy-Stuart, University of Cambridge, Paula Midgley, University of Edinburgh
  • Book: Practical Neonatal Endocrinology
  • Online publication: 15 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544736.028
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  • Dynamic tests
  • Amanda Ogilvy-Stuart, University of Cambridge, Paula Midgley, University of Edinburgh
  • Book: Practical Neonatal Endocrinology
  • Online publication: 15 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544736.028
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Dynamic tests
  • Amanda Ogilvy-Stuart, University of Cambridge, Paula Midgley, University of Edinburgh
  • Book: Practical Neonatal Endocrinology
  • Online publication: 15 February 2010
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544736.028
Available formats
×