Stimulated as Compared with Spontaneous Growth Hormone Levels for Diagnosis of Growth Hormone Deficiency

To the Editor: Rose et al. (July 28 issue)¹ propose that the diagnosis of growth hormone deficiency in prepubertal short children should be based on abnormal growth hormone secretory responses to provocative growth hormone–releasing stimuli rather than on spontaneous growth hormone secretion. We suggest that the secretory data need to be interpreted in the context of the clinical setting — i.e., short stature, poor growth velocity, and delayed bone age. One might question the diagnosis of growth hormone deficiency in some of their patients, who, for example, were growing as rapidly as 10 cm per year, since subnormal secretion of.