Shilpa Mehta1, Vikash Oza2, Renee Potashner3, Patricia Zamora1, Manish Raisingani1, Bina Shah1. 1. Department of Pediatrics, Division of Pediatric Endocrinology, New York University School of Medicine, New York, NY, USA. 2. The Ronald O. Perelman Department of Dermatology, Division of Pediatric Dermatology, New York University School of Medicine, New York, NY, USA. 3. Ruth and Bruce Rappaport School of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Abstract
BACKGROUND: Allergic and non-allergic skin reactions to recombinant human growth hormone (rhGH) are uncommon and infrequently reported. However, physicians should be aware of these potential side effects to determine whether the reactions constitute true allergies and how to proceed with growth hormone therapy. To review allergic and non-allergic skin reactions caused by rhGH and subsequent diagnostic workup and management options. CASE PRESENTATION: We report the case of a 12-year-old healthy male presenting with idiopathic short stature. He developed an itchy skin rash over the chest and abdomen, 15 min after administration of the first dose of rhGH, leading us to review allergic and non-allergic skin reactions to rhGH. In our patient, an immediate skin reaction after administration of rhGH prompted a concern about a type I hypersensitivity reaction (HS) and the discontinuation of rhGH. However, after a dermatologic evaluation and observed administration of rhGH without subsequent rash, the initial eruption was likely an exacerbation of his underlying atopic dermatitis and a type I HS was felt to be unlikely. The rhGH was resumed and he has been on rhGH for the past 1 year with no recurrence of rash and with improvement in growth velocity. CONCLUSIONS: Though rare, allergic and non-allergic skin reactions are known to occur with rhGH. It is important to know if the allergic reaction was due to the growth hormone molecule or one of the preservatives. It is also important to consider a non-allergic reaction due to flare up of underlying skin disorders as in our patient.
BACKGROUND:Allergic and non-allergic skin reactions to recombinant humangrowth hormone (rhGH) are uncommon and infrequently reported. However, physicians should be aware of these potential side effects to determine whether the reactions constitute true allergies and how to proceed with growth hormone therapy. To review allergic and non-allergic skin reactions caused by rhGH and subsequent diagnostic workup and management options. CASE PRESENTATION: We report the case of a 12-year-old healthy male presenting with idiopathic short stature. He developed an itchy skin rash over the chest and abdomen, 15 min after administration of the first dose of rhGH, leading us to review allergic and non-allergic skin reactions to rhGH. In our patient, an immediate skin reaction after administration of rhGH prompted a concern about a type I hypersensitivity reaction (HS) and the discontinuation of rhGH. However, after a dermatologic evaluation and observed administration of rhGH without subsequent rash, the initial eruption was likely an exacerbation of his underlying atopic dermatitis and a type I HS was felt to be unlikely. The rhGH was resumed and he has been on rhGH for the past 1 year with no recurrence of rash and with improvement in growth velocity. CONCLUSIONS: Though rare, allergic and non-allergic skin reactions are known to occur with rhGH. It is important to know if the allergic reaction was due to the growth hormone molecule or one of the preservatives. It is also important to consider a non-allergic reaction due to flare up of underlying skin disorders as in our patient.
Entities:
Keywords:
allergic reaction to growth hormone; growth hormone therapy; hypersensitivity reaction to growth hormone
Authors: Jake Mann; Dennis Caruana; Evelyn Luo; Eric Gottesman; Nidhi Agrawal; Daniel Lozeau; Justina Hessel; Melissa Neumann; Sameer Khanijo; Zubair Hasan; Khizer Rizvi; Regina Gunther; Daniel Donovan; Derek Chan; Mary Lee-Wong; Anthony M Szema Journal: Cureus Date: 2022-08-12