RESUMO
OBJECTIVE: To evaluate the association between recombinant human growth hormone (rhGH) treatment and intraocular pressure (IOP) in children. STUDY DESIGN: This is an observational cohort study including comparison between children treated with rhGH for at least 12 months (treatment group), matched children prior to treatment (control group), and population age-adjusted normograms of IOP. All children underwent an ocular slit lamp assessment and Goldmann applanation tonometry. Charts were reviewed for cause of therapy, peak stimulated growth hormone level prior to therapy, treatment duration, insulin-like growth factor 1, and rhGH dosage. RESULTS: The treatment group included 55 children and the control group included 24 children. Mean age at examination was comparable at 11.4 ± 3.3 years and 10.3 ± 2.6 years, respectively (P = .13). Mean treatment duration was 37.5 ± 22.8 months and mean rhGH dose was 0.04 ± 0.01 mg/kg/d. Mean IOP was significantly increased in the treatment group compared with the control group and compared with age-matched normograms (16.09 ± 2.2 mm Hg, 13.26 ± 1.83 mm Hg and 14.6 ± 1.97 mm Hg, respectively, P < .001). IOP was positively correlated with treatment duration (r = 0.559, P < .001) and rhGH dosage (r = 0.274, P = .043). CONCLUSION: IOP in children treated with rhGH is increased compared with a similar population without treatment and compared with healthy population normograms. IOP is associated with longer treatment duration and higher dosages.
Assuntos
Hormônio do Crescimento Humano/efeitos adversos , Pressão Intraocular/efeitos dos fármacos , Hipertensão Ocular/induzido quimicamente , Adolescente , Criança , Estudos de Coortes , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Hormônio do Crescimento Humano/administração & dosagem , Humanos , Masculino , Hipertensão Ocular/diagnóstico , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/efeitos adversos , Padrões de Referência , Método Simples-Cego , Fatores de Tempo , Tonometria Ocular/normasRESUMO
Autoimmune thyroiditis developed in a 9-year-old girl with precocious puberty approximately 8 months after initiation of Leuprolide acetate therapy. In addition, gonadotropin concentrations as measured by radioimmunoassay appeared high. Treatment with levothyroxine, in addition to continued Leuprolide acetate treatment, resolved gonadotropin elevation and hypothyroidism.