Liu Fujuan, Yuan Xiaoying, Yang Yanjun, Han Yanan, Ge Lanlan, Guo Jingxiao, Liu Ling, Li Chunzhen, Zhang Dongfeng
Department of Nephrology and Immunology, Children's Hospital of Hebei Province, China.
J Int Med Res. 2025 Jul;53(7):3000605251359426. doi: 10.1177/03000605251359426. Epub 2025 Jul 30.
Linear growth delay is common in children with systemic lupus erythematosus. There have been scattered reports of using recombinant human growth hormone in these children, but safety remains a major concern. We herein report two cases of successful treatment with recombinant human growth hormone in children with systemic lupus erythematosus: a 15-year 10-month-old boy (case 1; disease duration: 4 years; height: 149 cm (<3rd percentile, Z-score <-3); and bone age: 11 years) and a 12-year 8-month-old boy (case 2; disease duration: 5 years; height: 149.5 cm (10th percentile, Z-score = -1); and bone age: 12 years). Both children had been in complete remission for 6 and 30 months, respectively. Insulin-like growth factor-1, insulin-like growth factor-binding protein 3, adrenocorticotropic hormone, and cortisol levels were normal in both cases. Recombinant human growth hormone treatment lasted for 17 and 16 months, respectively. The height increase was 22 and 19 cm during the treatment period, respectively. Systemic lupus erythematosus remained in complete remission on maintenance therapy with hydroxychloroquine/tacrolimus and hydroxychloroquine/mycophenolate mofetil, respectively. Literature search identified two cases. At the time of recombinant human growth hormone treatment initiation, case 1 had proteinuria and elevated serum creatinine level, and case 2 had positive anti-double-stranded DNA antibodies. Relapse occurred immediately after recombinant human growth hormone treatment in both cases. In conclusion, recombinant human growth hormone treatment may be considered for linear growth delay in children with systemic lupus erythematosus if disease activity is sufficiently controlled.
线性生长迟缓在系统性红斑狼疮患儿中很常见。已有关于在这些患儿中使用重组人生长激素的零散报道，但安全性仍是主要关注点。我们在此报告两例系统性红斑狼疮患儿使用重组人生长激素治疗成功的病例：一名15岁10个月大的男孩（病例1；病程：4年；身高：149厘米（<第3百分位数，Z评分<-3）；骨龄：11岁）和一名12岁8个月大的男孩（病例2；病程：5年；身高：149.5厘米（第10百分位数，Z评分=-1）；骨龄：12岁）。两名患儿分别已完全缓解6个月和30个月。两例患儿的胰岛素样生长因子-1、胰岛素样生长因子结合蛋白3、促肾上腺皮质激素和皮质醇水平均正常。重组人生长激素治疗分别持续了17个月和16个月。治疗期间身高分别增加了22厘米和19厘米。系统性红斑狼疮在分别使用羟氯喹/他克莫司和羟氯喹/霉酚酸酯维持治疗时仍处于完全缓解状态。文献检索发现两例病例。在开始重组人生长激素治疗时，病例1有蛋白尿和血清肌酐水平升高，病例2抗双链DNA抗体呈阳性。两例病例在重组人生长激素治疗后均立即复发。总之，如果疾病活动得到充分控制，对于系统性红斑狼疮患儿的线性生长迟缓可考虑使用重组人生长激素治疗。
