Safety issues in children and adolescents during growth hormone therapy--a review.
The action of growth hormone (GH) via its receptor involves many organ systems and metabolic pathways. These diverse actions are reviewed in this paper in the context that they may represent unwanted side-effects of GH therapy for growth promotion. The monitoring of GH therapy in large multicentre international databases has demonstrated a low frequency of adverse events. Tumour recurrence or new malignancy are not increased. Headaches, especially in the first few months of therapy, require close evaluation as benign intracranial hypertension is found infrequently, especially in children with GH deficiency and chronic renal failure (CRF). Children at risk for slipped capital femoral epiphysis and scoliosis require close monitoring during therapy. Decreased insulin sensitivity that is dose-dependent is observed during GH therapy. Glucose homeostasis, however, is not affected, but a recent report of increased incidence of Type 2 diabetes mellitus in children undergoing GH therapy requires prospective surveillance.
Clayton
P E
PE
Department of Child Health, Royal Manchester Children's Hospital, Manchester, UK.
Cowell
C T
CT
D000293:Adolescent; D050260:Carbohydrate Metabolism; D002648:Child; D004838:Epiphyses / Q000187:drug effects; D012739:Gonadal Steroid Hormones / Q000378:metabolism; D019382:Human Growth Hormone / Q000378:metabolism* / Q000627:therapeutic use*; D006801:Humans; D007107:Immune System / Q000187:drug effects; D050356:Lipid Metabolism; D011559:Pseudotumor Cerebri / Q000378:metabolism; D051437:Renal Insufficiency / Q000188:drug therapy; D012160:Retina / Q000187:drug effects; D012640:Seizures / Q000209:etiology; D012867:Skin / Q000187:drug effects; D012964:Sodium / Q000378:metabolism; D013961:Thyroid Gland / Q000378:metabolism; D014867:Water / Q000378:metabolism
D012739:Gonadal Steroid Hormones; D014867:Water; D019382:Human Growth Hormone; D012964:Sodium