Allergic and non-allergic skin reactions associated with growth hormone therapy: elucidation of causative agents

Mehta, Shilpa; Oza, Vikash S.; Potashner, Renee; Zamora, Patricia; Raisingani, Manish; Shah, Bina

doi:10.1515/jpem-2017-0309

Cited by 6 publications

(2 citation statements)

References 33 publications

(47 reference statements)

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“…The rash was biopsied, and the patient was presented at a University Dermatology Grand Rounds [10] where the panel of dermatologists concluded the rash to be most consistent with symmetric drug-related intertriginous and flexural exanthema (Figure 3). The patient was instructed to discontinue Norditropin FlexPro®; the rash resolved spontaneously over several months.…”

Section: Figure 2: Dermal Eruptions In Response To Growth Hormone The...mentioning

confidence: 99%

Attenuation of Human Growth Hormone-Induced Rash With Graded Dose Challenge

Mann¹,

Caruana²,

Luo³

et al. 2022

Cureus

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Adult growth hormone (GH) deficiency is rare and requires replacement with extrinsic/synthetic injection. GH hypersensitivity has been reported; specifically, atopic patients may develop rashes from somatotropin therapy. Allergic and non-allergic skin reactions to recombinant human GH are uncommon and infrequently reported. We describe a graded-dose challenge with intravenous Norditropin® in a 65-year-old atopic adult woman who developed a severe whole-body rash with Norditropin FlexPro® administration on several occasions but was negative on skin-prick testing to Norditropin® percutaneously and intradermally, but the patch testing was positive for gold and nickel.The patient was registered as a direct admission to the emergency room at a university hospital for a rapid antigen coronavirus disease 2019 (COVID-19) testing after having received two COVID-19 vaccinations and re-testing four months after vaccination. She was then directly admitted to a non-COVID-19 intensive care unit with direct bedside supervision by a registered nurse and a physician board certified in internal medicine, allergy/immunology, and pulmonary diseases. The patient brought a Norditropin® pen which our pharmacy team attached to a compatible syringe for dilutions. A graded dose challenge at a final dosage of 0.1 mL was performed and the patient was monitored for allergic and other adverse drug reactions, which did not occur. At the time of writing this case report, the patient has been maintained on Norditropin FlexPro® 0.1 mL and has not experienced any adverse reactions, including recurrent skin eruptions.The case presented is the first to describe a patient who successfully tolerated a graded dose challenge of an adult patient to GH replacement therapy (as Norditropin®) under supervision in an intensive care unit, whereas prior to reporting of this case, a graded dose challenge to GH replacement therapy had only been successfully performed in a child using another formulation of somatotropin (Humatrope®). Hence, this case lends support that graded dose challenge with somatotropin analogs may be considered for patients with isolated GH deficiency such as in the case presented here.

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Section: Figure 2: Dermal Eruptions In Response To Growth Hormone The...mentioning

confidence: 99%

Attenuation of Human Growth Hormone-Induced Rash With Graded Dose Challenge

Mann¹,

Caruana²,

Luo³

et al. 2022

Cureus

View full text Add to dashboard Cite

show abstract

“…The study by Mehta et al [13] describes a 12-year-old boy with idiopathic short stature who developed an itchy skin rash 15 min after the administration of a first dose of GH. The rash was later found to be the exacerbation of the underlying atopic dermatitis in this patient.…”

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confidence: 99%