Aplastic anemia during growth hormone (GH) treatment in a girl with idiopathic GH-deficiency

Endocr J. 2003 Aug;50(4):469-71. doi: 10.1507/endocrj.50.469.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Anemia, Aplastic / chemically induced*
  • Antilymphocyte Serum / therapeutic use
  • Child
  • Chromosomes, Human, Pair 8*
  • Female
  • Glucocorticoids / therapeutic use
  • Human Growth Hormone / adverse effects*
  • Human Growth Hormone / deficiency*
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Methylprednisolone / therapeutic use
  • Recombinant Proteins / adverse effects
  • Trisomy*

Substances

  • Antilymphocyte Serum
  • Glucocorticoids
  • Immunosuppressive Agents
  • Recombinant Proteins
  • Human Growth Hormone
  • Methylprednisolone