Mehta Shilpa, Oza Vikash, Potashner Renee, Zamora Patricia, Raisingani Manish, Shah Bina
Department of Pediatrics, Division of Pediatric Endocrinology, New York University School of Medicine, New York, NY, USA.
The Ronald O. Perelman Department of Dermatology, Division of Pediatric Dermatology, New York University School of Medicine, New York, NY, USA.
J Pediatr Endocrinol Metab. 2018 Jan 26;31(1):5-11. doi: 10.1515/jpem-2017-0309.
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.
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.
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.
重组人生长激素（rhGH）引起的过敏性和非过敏性皮肤反应并不常见，报告也很少。然而，医生应了解这些潜在的副作用，以确定这些反应是否构成真正的过敏以及如何继续进行生长激素治疗。旨在回顾由rhGH引起的过敏性和非过敏性皮肤反应以及后续的诊断检查和管理方案。
我们报告了一名12岁健康男性特发性身材矮小的病例。他在首次注射rhGH后15分钟，胸部和腹部出现瘙痒性皮疹，这促使我们回顾对rhGH的过敏性和非过敏性皮肤反应。在我们的患者中，注射rhGH后立即出现皮肤反应引发了对I型超敏反应（HS）的担忧，并停用了rhGH。然而，经过皮肤科评估并观察到再次注射rhGH后未出现皮疹，最初的皮疹可能是其潜在特应性皮炎的加重，I型HS的可能性不大。rhGH得以恢复使用，在过去1年里他一直在使用rhGH，皮疹未再复发，生长速度有所改善。
虽然罕见，但rhGH已知会引起过敏性和非过敏性皮肤反应。了解过敏反应是由于生长激素分子还是其中一种防腐剂引起很重要。考虑到像我们患者这样因潜在皮肤疾病发作引起的非过敏反应也很重要。
