Self-limiting hematuria following growth hormone provocative testing with arginine hydrochloride

Evaluation of growth hormone (GH) deficiency often involves use of agents that stimulate GH secretion, such as clonidine, glucagon, insulin, levo-dopa or arginine hydrochloride. We present three pediatric cases of benign, macroscopic hematuria in children without pre-existing renal disease following GH stimulation testing with clonidine and arginine hydrochloride. In all cases hematuria resolved spontaneously within 3-4 days without any intervention. This suggests that careful observation in such cases is sufficient and additional costly evaluation may be avoided. Other than six anecdotal cases registered via on-line adverse event reporting system (AERS), this is the first published report to date of painless, macroscopic, self-limiting hematuria after arginine hydrochloride infusion.