Aplastic anemia during growth hormone (GH) treatment in a girl with idiopathic GH-deficiency.
We report a 12-year-old girl with aplastic anemia accompanied by chromosome 8 trisomy during growth hormone (GH) therapy. When she was six years old she was diagnosed as idiopathic isolated GH deficiency, and GH therapy (0.175 mg/kg/week) was initiated. At the age 12, she began to exhibit petechiae in both lower limbs. Platelet count was 11,000/microL; serum hemoglobin level 11.8 gr/mL; white blood cell count 3,400/microL, with 37% neutrophils, 58% lymphocytes, 4% monocytes and 1% basophils. Bone marrow examination showed that total nucleated cell count and megakaryocyte were 17,000/microL and 0/microL, respectively, suggesting low formation. In addition, 13% of bone marrow cells contained the 3 signals of chromosome 8 marker (trisomy 8). She was diagnosed as aplastic anemia accompanied with chromosome 8 trisomy. GH therapy was stopped immediately, and simultaneous administration of methylprednisolone and anti-thymocyte globulin was initiated. Platelet count improved with treatment, and the 3-signal chromosome 8 abnormality disappeared from the bone marrow cells. The fact that a hematological adverse effect other than leukemia exists in conjunction with GH therapy warrants further investigation into possible hematological changes occurring during or after GH therapy.
Division of Pediatrics & Perinatology, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan.
Shuji
S
Sugimoto
Keiichi
K
Hanaki
Yuki
Y
Kawashima
Tomoe
T
Kinoshita
Jun-ichi
J
Nagaishi
Atsushi
A
Hayashi
Susumu
S
Kanzaki
D000741:Anemia, Aplastic / Q000139:chemically induced*; D000961:Antilymphocyte Serum / Q000627:therapeutic use; D002648:Child; D002898:Chromosomes, Human, Pair 8; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000009:adverse effects* / Q000172:deficiency*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008775:Methylprednisolone / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000009:adverse effects; D014314:Trisomy
D000961:Antilymphocyte Serum; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011994:Recombinant Proteins; D019382:Human Growth Hormone; D008775:Methylprednisolone