Case - Hematuria with clot retention after clonidine/arginine growth hormone stimulation test

Area of Science:

• Pediatric Endocrinology
• Urology

Background:

• Arginine and clonidine stimulation tests are common for evaluating growth hormone (GH) deficiency in children.
• These tests are generally considered safe, with known side effects including transient, painless hematuria.

Purpose of the Study:

• To report a case of significant, painful hematuria with clot retention following a GH stimulation test.
• To highlight a previously undocumented complication of arginine and clonidine testing.

Main Methods:

• A pre-pubertal child underwent a standard GH stimulation test using arginine and clonidine.
• Clinical presentation, diagnostic workup (including ultrasound), and management of the complication were documented.

Main Results:

• The patient developed painful gross hematuria with clot retention post-testing.
• Expectant outpatient management led to spontaneous resolution of bladder clots confirmed by ultrasound.

Conclusions:

• Arginine and clonidine GH stimulation tests carry a risk of causing severe hematuria with clot retention, a complication not previously described.
• This potential adverse event may necessitate medical intervention and warrants clinical awareness.