<Case Report>Failure of Growth Hormone Therapy in a Girl with Growth Hormone Deficiency and Steroid-induced Growth Failure Caused by Prednisolone Administration

概要

論文の詳細を見る
We administered recombinant growth hormone (rGH) to a girl with systemic lupus erythematosus (SLE) complicated by steroid-induced growth failure and GH deficiency. However, the rGH therapy, which she underwent for 14 months, was not effective. The patient was diagnosed as SLE when she was 4 years and 10 months old, and her height before undergoing prednisolone was -1.0 SD score (SDS). She was treated with prednisolone (0.4-0.5 mg/kg/day) for a prolonged period. She was referred to us at 9 years of age because of persistent proteinuria that had begun when she was 7 years and 8 months old. We performed a renal biopsy (WHO SLE IIIA type) and noticed steroid-induced growth failure (-4.2 SDS), delay of bone maturation (5 years of age) and a low response to GH in the arginine and clonizine-loading test. We prescribed rGH therapy (0.175 mg/kg/week) and attempted to decrease prednisolone by administering cyclosporin A or mizolibine. However, prednisolone could not be decreased to less than 0.35 mg/kg/day for a long period. GH therapy for 14 months increased her height by only 2.8 cm (-4.4 SDS). The observations made in this SLE patient are consistent with those of Rivkees et al., who reported that when the prednisolone dose is greater than 0.35 mg/kg/day, rGH therapy does not increase the linear growth rate.
獨協医科大学の論文
2003-03-25