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Growth hormone therapy does not impact the development of intracranial hypertension in children with Chiari malformation.
Krasnow, Matthew D; McGuirk, Liam; Alexandrov, Alice; Naparst, Monica; Patale, Tara; Mehta, Shilpa; Noto, Richard.
Afiliación
  • Krasnow MD; Department of Pediatrics, New York Medical College, Valhalla, NY, USA.
  • McGuirk L; 228379 Donald and Barbara Zucker School of Medicine at Hofstra/Northwell , Hempstead, NY, USA.
  • Alexandrov A; Department of Pediatrics, New York Medical College, Tarrytown, NY, USA.
  • Naparst M; Department of Pediatrics, New York Medical College, Valhalla, NY, USA.
  • Patale T; Department of Pediatrics, New York Medical College, Valhalla, NY, USA.
  • Mehta S; Diabetes and Endocrine Center for Children and Young Adults, Hawthorne, NY, USA.
  • Noto R; New York Medical College, Sleepy Hollow, NY, USA.
J Pediatr Endocrinol Metab ; 37(7): 630-634, 2024 Jul 26.
Article en En | MEDLINE | ID: mdl-38776636
ABSTRACT

OBJECTIVES:

Patients with Chiari malformation (CM) are prone to a variety of neurological sequelae, including benign intracranial hypertension (BIH). In these patients, BIH is attributed to impaired cerebrospinal fluid (CSF) flow due to anatomical abnormalities of the posterior fossa. Occasionally, patients with CM may require growth hormone therapy (GHT), which can increase the production of CSF. It is thought that patients with CM who undergo GHT are at high risk of BIH-associated symptoms (BIHAS). We describe the incidence of neurological symptoms in 34 patients with CM before and during GHT.

METHODS:

The database of a pediatric endocrinology center was queried for patients with CM who received GHT from 2010-22. Records were reviewed for adverse events. Demographic and radiological data were collected and analyzed. Patients with neoplastic disease, active inflammation, or acute trauma were excluded. CM diagnoses were independently assigned by a neuroradiology department. Patients were grouped based on the presence and nature of symptoms before and during GHT. Relationships between starting dose/BMI and occurrence of BIHAS/all GHT-associated symptoms were evaluated.

RESULTS:

GHT was not associated with new-onset or worsening of preexisting BIHAS in 33 out of 34 patients with CM. Five complex patients continued to have preexisting BIHAS, which did not worsen. Of the four patients who developed new-onset BIHAS during GHT, three patients' symptoms were attributed to other medical conditions. No patient permanently discontinued GHT due to BIHAS.

CONCLUSIONS:

Growth hormone therapy is likely a safe treatment in patients with Chiari malformation and is unlikely to cause BIHAS.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Malformación de Arnold-Chiari / Hormona de Crecimiento Humana / Hipertensión Intracraneal Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: J Pediatr Endocrinol Metab Asunto de la revista: ENDOCRINOLOGIA / PEDIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Malformación de Arnold-Chiari / Hormona de Crecimiento Humana / Hipertensión Intracraneal Límite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Revista: J Pediatr Endocrinol Metab Asunto de la revista: ENDOCRINOLOGIA / PEDIATRIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Alemania