Arginine test is not reliable for diagnosing cerebellar multiple system atrophy

• Published in: Annals of neurology Vol. 67; no. 3; pp. 404 - 408
• Main Authors: Gardner, Raquel C., Schmahmann, Jeremy D.
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.03.2010; Wiley-Liss
• Subjects: Adult; Arginine - analysis; Arginine - blood; Biological and medical sciences; Biomarkers - analysis; Biomarkers - blood; Blood Chemical Analysis - methods; Blood Chemical Analysis - standards; Cerebellar Ataxia - blood; Cerebellar Ataxia - diagnosis; Cerebellar Ataxia - physiopathology; Diagnosis, Differential; Female; Growth Hormone - analysis; Growth Hormone - blood; Humans; Male; Medical sciences; Middle Aged; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Multiple System Atrophy - blood; Multiple System Atrophy - diagnosis; Multiple System Atrophy - physiopathology; Neurology; Predictive Value of Tests; Reproducibility of Results; Sensitivity and Specificity; Cerebellum; Multiple system atrophy; Nervous system diseases; Arginine; Central nervous system; Encephalon
• ISSN: 0364-5134; 1531-8249; 1531-8249
• DOI: 10.1002/ana.21898

We evaluated the arginine growth hormone (GH) stimulation test for the diagnosis of cerebellar‐type multiple system atrophy (MSAc) in patients with ataxia. Fourteen subjects with MSAc, 11 with idiopathic late‐onset cerebellar ataxia (ILOCA), 10 with familial ataxia, and 10 healthy controls were tested. After pituitary GH deficiency was excluded, subjects underwent arginine testing. Peak serum GH response was analyzed. No significant differences in peak GH response were found between subject populations. Thirty‐three percent of MSAc subjects mounted responses >10μg/l GH. Thirty‐six percent of ILOCA subjects and 40 percent of healthy controls mounted responses <4μg/l GH. Arginine thus appears to be unreliable for the diagnosis of MSAc. ANN NEUROL 2010;67:404–408