Myalgia and Hematuria in Association with Clonidine and Arginine Administration for Growth Hormone Stimulation Tests

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Meghan Glibbery1,2,3, Adam Fleming1,4, Rahul Chanchlani1,5

  • 1Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada.

Case Reports in Medicine
|June 18, 2020
PubMed

Insights

Growth hormone deficiency (GHD) diagnosis involves stimulation tests, which are generally safe. This case details rare side effects, including myalgia and hematuria, after clonidine and arginine administration in a child.

Area of Science:

  • Pediatric Endocrinology
  • Clinical Pharmacology

Background:

  • Growth hormone deficiency (GHD) impacts childhood growth and metabolism.
  • Two-agent growth hormone (GH) stimulation tests are standard diagnostic tools for GHD.

Observation:

  • A 5-year-old boy with a history of anaplastic ependymoma experienced bilateral calf myalgia and gross hematuria post-GH stimulation testing.
  • The adverse events, myalgia and hematuria, resolved spontaneously without intervention.

Findings:

  • Literature review identified 6 cases of hematuria with clonidine and 20 cases with arginine.
  • This case presents an unusual combination of adverse reactions to clonidine and arginine during GH testing.

Implications:

  • Pediatric endocrinologists should be aware of potential myalgia and hematuria side effects from clonidine and arginine GH stimulation tests.
  • Further research is needed to elucidate the mechanisms and incidence of these adverse reactions.
  • Counseling patients and families on the potential for hematuria associated with GH testing using these agents is recommended.

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