title: Focal segmental glomerulosclerosis in a case of panhypopituitarism: a possible role of growth hormone treatment.
abstract: Panhypopituitarism manifests various symptoms including growth failure, hypothyroidism, adrenal insufficiency and hypogonadism. Dwarfism is an important problem in children with this condition, and long-term treatment with recombinant human growth hormone (GH) is usually required. We report a 24-year-old man with panhypopituitarism complicated by focal segmental glomerulosclerosis (FSGS). The patient had been treated with GH for hypopituitary dwarfism from 3 years of age. Proteinuria was initially noticed at 15 years of age and persisted despite cessation of GH supplementation at 18 years of age. A renal biopsy specimen showed glomerular hypertrophy and limited glomerulosclerosis, compatible with FSGS. To our knowledge, this is the first reported case of panhypopituitarism complicated by FSGS. Our case suggests that GH treatment for dwarfism may induce irreversible glomerular disease.
authors.affiliation: First Department of Medicine, Hamamatsu University School of Medicine, Japan. fukasawa@hama-med.ac.jp
authors.forename: H
authors.initials: H
authors.lastname: Fukasawa
authors.forename: A
authors.initials: A
authors.lastname: Kato
authors.forename: T
authors.initials: T
authors.lastname: Fujimoto
authors.forename: H
authors.initials: H
authors.lastname: Suzuki
authors.forename: Y
authors.initials: Y
authors.lastname: Fujigaki
authors.forename: T
authors.initials: T
authors.lastname: Yamamoto
authors.forename: A
authors.initials: A
authors.lastname: Endoh
authors.forename: K
authors.initials: K
authors.lastname: Yonemura
authors.forename: A
authors.initials: A
authors.lastname: Hishida
mesh_terms: D000328:Adult; D005923:Glomerulosclerosis, Focal Segmental / Q000139:chemically induced*; D019382:Human Growth Hormone / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007018:Hypopituitarism / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use*; D013995:Time; D016896:Treatment Outcome
chemical_list: D011994:Recombinant Proteins; D019382:Human Growth Hormone