Treatment of Growth Hormone Deficiency via Daily Intravascular Injections in a Child with Bleeding Disorder

Objectives. The standard of treatment for pediatric growth hormone deficiency (GHD) is daily subcutaneous recombinant human growth hormone (rhGH) injections. The efficacy of rhGH treatment given as daily intravenous (IV) boluses is not known. Case Presentation. A female with protein C deficiency, a...

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Main Authors: Emir Tas, Serife E. Uzun, Vildan Tas, Juan D. Mejia-Otero
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:Case Reports in Endocrinology
Online Access:http://dx.doi.org/10.1155/2021/7865398
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author Emir Tas
Serife E. Uzun
Vildan Tas
Juan D. Mejia-Otero
author_facet Emir Tas
Serife E. Uzun
Vildan Tas
Juan D. Mejia-Otero
author_sort Emir Tas
collection DOAJ
description Objectives. The standard of treatment for pediatric growth hormone deficiency (GHD) is daily subcutaneous recombinant human growth hormone (rhGH) injections. The efficacy of rhGH treatment given as daily intravenous (IV) boluses is not known. Case Presentation. A female with protein C deficiency, a severe bleeding disorder characterized by thrombosis formation, was diagnosed with GHD at age four years. She has been receiving daily protein C infusion through a permanent port since the newborn period. GHD was treated with daily IV rhGH boluses given through the port following protein C infusion. She has reached a growth rate of 12 cm/year and had no side effects. Surprisingly, serum insulin-like growth factor-1 (IGF1) levels did not rise despite an excellent clinical response. Conclusions. IV administration may be an alternative route for GHD treatment in eligible patients with permanent vascular access. A rise in serum IGF1 levels may not be needed to achieve the growth-promoting effect of rhGH.
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spelling doaj-art-60f2b3a1f3de4e569be273042db7ce732025-08-20T02:35:18ZengWileyCase Reports in Endocrinology2090-65012090-651X2021-01-01202110.1155/2021/78653987865398Treatment of Growth Hormone Deficiency via Daily Intravascular Injections in a Child with Bleeding DisorderEmir Tas0Serife E. Uzun1Vildan Tas2Juan D. Mejia-Otero3Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USACollege of Osteopathic Medicine, New York Institute of Technology, Glen Head, Long Island, NY, USADepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USADepartment of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USAObjectives. The standard of treatment for pediatric growth hormone deficiency (GHD) is daily subcutaneous recombinant human growth hormone (rhGH) injections. The efficacy of rhGH treatment given as daily intravenous (IV) boluses is not known. Case Presentation. A female with protein C deficiency, a severe bleeding disorder characterized by thrombosis formation, was diagnosed with GHD at age four years. She has been receiving daily protein C infusion through a permanent port since the newborn period. GHD was treated with daily IV rhGH boluses given through the port following protein C infusion. She has reached a growth rate of 12 cm/year and had no side effects. Surprisingly, serum insulin-like growth factor-1 (IGF1) levels did not rise despite an excellent clinical response. Conclusions. IV administration may be an alternative route for GHD treatment in eligible patients with permanent vascular access. A rise in serum IGF1 levels may not be needed to achieve the growth-promoting effect of rhGH.http://dx.doi.org/10.1155/2021/7865398
spellingShingle Emir Tas
Serife E. Uzun
Vildan Tas
Juan D. Mejia-Otero
Treatment of Growth Hormone Deficiency via Daily Intravascular Injections in a Child with Bleeding Disorder
Case Reports in Endocrinology
title Treatment of Growth Hormone Deficiency via Daily Intravascular Injections in a Child with Bleeding Disorder
title_full Treatment of Growth Hormone Deficiency via Daily Intravascular Injections in a Child with Bleeding Disorder
title_fullStr Treatment of Growth Hormone Deficiency via Daily Intravascular Injections in a Child with Bleeding Disorder
title_full_unstemmed Treatment of Growth Hormone Deficiency via Daily Intravascular Injections in a Child with Bleeding Disorder
title_short Treatment of Growth Hormone Deficiency via Daily Intravascular Injections in a Child with Bleeding Disorder
title_sort treatment of growth hormone deficiency via daily intravascular injections in a child with bleeding disorder
url http://dx.doi.org/10.1155/2021/7865398
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