Abstract
With the availability of rDNA-GH, GH is applied in experimental trials to other groups of patients than with GH-deficiency. Most effects of GH and GH-factors are clear; an effect of malignant degeneration is unknown.
Patient. In a 12.3 yrs old girl with idiopathic GH-deficiency pit-GH was instituted with 2 × 4 IU/wk/im (12.7 IU/m2/wk) at 5.5 yrs. At 6.6 yrs a pericarditis of unknown origin developed; pericardectomy was necessary. At 9.7 yrs GH treatment was stopped and resumed at 10.3 yrs with rDNA-GH 6 × 2 IU/wk/sc (12 IU/m2/wk). Throughout GH treatment growth was satisfactory.
At 11.2 yrs she had muscle weakness resulting in failure to walk. Neurological, (including muscle biopsy) and laboratory investigation did not reveal abnormalities. Prednisone improved the weakness temporarily. She developed anaemia and hepato-splenomegaly and on examination of blood and bone marrow a diagnosis of a CALLA-positive acute lymphocytic leukemia was made. The leukemic cells did not show chromosomal aberrations. Cytotoxic treatment resulted in complete remission and disappearance of the muscle weakness.
Conclusion. A 12.3 yrs old girl developed common ALL, while on GH treatment. No causal relationship could be proven. However, this case is reason to stress the necessity of strict indications for GH treatment.
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Delemarre-van de Wall, H., Odink, R., De Grauw, T. et al. 103 ACUTE LYMPHOCYTIC LEUKEMIA IN A PATIENT ON GROWTH HORMONE (GH) TREATMENT. Pediatr Res 24, 534 (1988). https://doi.org/10.1203/00006450-198810000-00124
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DOI: https://doi.org/10.1203/00006450-198810000-00124
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