Anemia secondary to valproic acid therapy in a 13-year-old boy: a case report.

INTRODUCTION: Valproic acid is a commonly used anti-epileptic drug. Hematological toxicities are among the occasionally observed adverse effects of this medication. CASE PRESENTATION: We present the case of a 13-year-old Caucasian boy who demonstrated mild anemia 12 months after the introduction of valproic acid therapy. A bone marrow biopsy revealed maturation arrest of proerythroblasts. CONCLUSION: Prompt diagnosis and valproic acid discontinuation resulted in the patient's recovery.

[The evaluation of the influence of growth hormone therapy on growing process and metabolic functions in patients after treatment of craniopharyngioma]. / Ocena wplywu terapii hormonem wzrostu na przebieg wzrastania i funkcje metaboliczne u pacjentów po leczeniu craniopharyngioma.

INTRODUCTION: Craniopharyngioma (CP) is a tumor, which damages pituitary function because of its localization. Panhypopituitarism (PHP) and excessive weight gain with lipid dysfunction are frequently observed. The growth hormone therapy (rGH) profits in the increase of growth rate and also may have metabolic effects like body weight reduction. AIM OF THE STUDY: The evaluation of benefits from rGH therapy in patients cured from CP. MATERIAL AND METHODS: 12 patients (7 boys and 5 girls) treated for CP with surgery; 3 of them also underwent radiotherapy. The mean age at examination time was 11.7 yrs; remission time 2.96 yrs; rGH therapy started on average 3.69 yrs after the surgery. Height (hSDS), weight, BMI were measured after the surgery, before and after 1 yr of rGH treatment. Height velocity (HV) was evaluated before and after 1 yr of rGH therapy. Pituitary GH-function was assessed. In addition, measurements of TSH, ACTH, LH, FSH. Cholesterol, LDL, HDL, triglycerides and HbA1c were estimated before and after one year of rGH therapy. RESULTS: All patients presented PHP. The GH-peak average 1.53 mIU/l; IGF-1 39.37 ng/ml; TSH 0.1 U/l; ACTH 17.48 pg/ml; LH 0.13 U/l; FSH 0.41 mIU/ml. HSDS after oncological treatment (OT) average -1.66 SD and decreased significantly until rGH therapy; weight after OT average 28.45 kg and until rGH therapy increased significantly; BMI after OT average 19.26 and increased significantly until rGH therapy as well. HV was on average 3.34 cm/yr until rGH started. After one year of rGH therapy hSDS and HV increased significantly; they average -1.65SD and 10.21 cm/yr respectively. BMI, HbA1c and LDL decreased significantly. During rGH therapy neither tumor recurrence nor severe side effects were observed. CONCLUSIONS: rGH therapy of patients cured from CP influences profitably not only growth rate, but also BMI reduction and the decrease in cholesterol LDL and HbA1c.