Intravenous metyrapone testing. Evaluation of growth hormone and adrenocorticotrophic hormone in children.

An intravenous metyrapone tartrate test was performed on 26 children to assess growth hormone (GH) reserve and pituitary-adrenal axis. Results were compared to the response evoked by an estrogen-primed arginine-insulin tolerance test (ATT/ITT). Administration of metyrapone intravenously proved to be a reliable means of evaluating pituitary-adrenal function. However, a normal serum GH concentration (greater than or equal to 7 ng/ml) during the test occurred in only nine of 18 children who had an adequate response to the ATT/ITT, and in three of these, the peak GH level occurred at the start of the infusion. Therefore, this procedure does not appear to be a satisfactory test for GH reserve in children. Further, the discrepancy between time of the peak serum concentrations of compound S and GH following intravenous administration of metyrapone does not support the contention that the rise of GH level during stress is secondary to release of adrenocorticotrophic hormone.