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CASE REPORT
Reversible brain lesion following growth hormone replacement therapy in an adolescent
  1. Adamos Hadjipanayis1,
  2. Elisavet Efstathiou2,
  3. Leda Theophilou3,
  4. George Chrousos4
  1. 1School of Medicine, Larnaca General Hospital, European University Cyprus, Larnaca, Cyprus
  2. 2Pediatric, Larnaca General Hospital, Larnaca, Cyprus
  3. 3St George’s University of London, University of Nicosia, Nicosia, Cyprus
  4. 4Department of Pediatrics, National and Kapodistrian University of Athens, Athens, Greece
  1. Correspondence to Dr Adamos Hadjipanayis, adamos{at}paidiatros.com

Summary

A 12.6-year-old girl presented with a 2-month history of headache, recurrent vomiting and 5 kg weight loss. She had been receiving recombinant human growth hormone (rhGH) replacement therapy at a dose of 0.035 mg/kg for the past 10 months, due to short stature. Investigations before initiating rhGH, including brain MRI, had been normal. Physical examination revealed a nystagmus and a mildly elevated arterial blood pressure. Brain MRI revealed a lesion in the posterior aspect of the medulla oblongata, adjacent to the foramen of Magendie. rhGH therapy was discontinued, followed by a gradual resolution of the symptoms. At follow-up 3 months later, she was asymptomatic and physical examination was unremarkable. A subsequent repeat brain MRI showed complete resolution of the lesion, supporting the diagnosis of a variant of reversible posterior leucoencephalopathy syndrome. This is the first case report of a reversible brain lesion linked to rhGH replacement therapy.

  • drugs: endocrine system
  • paediatrics
  • radiology
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Footnotes

  • Contributors AH: conception, design of the work, drafting the article, critical revision of the article, final approval of the version to be published. EE: drafting the article, critical revision of the article, final approval of the version to be published. LT: critical revision of the article, final approval of the version to be published. GC: critical revision of the article, final approval of the version to be published.

  • Competing interests None declared.

  • Patient consent Guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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