Hematuria as an adverse outcome following provocative growth hormone stimulation testing in children
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Rajeev Thirunagari
Abstract
Background:
Provocative growth hormone (GH) stimulation testing is used to evaluate short stature and growth failure in children. Agents commonly used for testing include clonidine, arginine and glucagon. While stimulation testing is generally considered safe, gross hematuria has been described as a rare idiopathic complication of GH stimulation testing. This study was designed to estimate the incidence of both microscopic and macroscopic hematuria following GH testing with different provocative agents.
Methods:
Subjects undergoing GH stimulation testing were invited to participate in the study. Prior to testing, vital signs were measured and baseline point-of-care (POC) urinalysis was done. The subjects performed urine testing at home on days 1, 2, 3 and 7 following GH stimulation studies. Families notified the study team with any positive findings and returned the data collection tool by mail.
Results:
In total, 34 subjects aged 11.14±2.71 years (91.2% male) completed the study. Agents used in provocative testing included arginine (73.5%), clonidine (94.1%) and glucagon (32.4%). Three subjects developed hematuria after GH stimulation testing (clonidine/arginine). The hematuria resolved by 7 days after testing. Additional adverse effects included nausea, vomiting and hypotension.
Conclusions:
In this study of children undergoing GH testing, hematuria was identified in three subjects. This study demonstrates that side effects to agents used for GH testing are self-limited, yet not rare, and should be discussed with patients and families prior to stimulation testing.
Acknowledgments
We would like to thank Barbara Shine, BSN, for her assistance with subject recruitment. We would also like to acknowledge the expertise of the staff of the ambulatory infusion unit at Women and Children’s Hospital of Buffalo, Kaleida Health where this study was carried out.
Author contributions: Study design: RT and LDM. Study conduct, data collection and data analysis: RT, AM, HE and LDM. Data interpretation: RT and LDM. Writing and revising manuscript: RT and LDM. Approving final manuscript: RT, AM, HE and LDM. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2018 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Review
- Review and evaluation of patient-centered psychosocial assessments for children with central precocious puberty or early puberty
- Mini Review
- Childhood obesity: how long should we wait to predict weight?
- Original Articles
- Glycated hemoglobin A1c as a screening test for detecting type 2 diabetes mellitus in obese children and adolescents
- Effect of a multidisciplinary treatment program on eating behavior in overweight and obese preschool children
- Cord blood klotho levels are inversely associated with leptin in healthy Latino neonates at risk for obesity
- Still too little, too late? Ten years of growth hormone therapy baseline data from the NordiNet® International Outcome Study
- Body composition and metabolic health of young male adults with childhood-onset multiple pituitary hormone deficiency after cessation of growth hormone treatment
- Hematuria as an adverse outcome following provocative growth hormone stimulation testing in children
- Bone mineral density comparison of adolescents with constitutional thinness and anorexia nervosa
- Adult height in patients with familial male-limited precocious puberty and the role of an aromatase inhibitor in patient management
- Association between UCP polymorphisms and adipokines with obesity in Mexican adolescents
- Impact of childhood type 1 diabetes on maternal work-family relations
- Case Reports
- Hyperthyroidism in an infant of a mother with autoimmune hypothyroidism with positive TSH receptor antibodies
- Sanjad-Sakati syndrome with macrocytic anemia and failure to thrive: a case from South Jordan
- In iodine-induced thyrotoxicosis, steroid therapy today could keep the surgical knife at bay
- Graves’ disease following allogenic hematopoietic stem cell transplantation for severe aplastic anemia: case report and literature review
