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Continuous Subcutaneous Infusion of Recombinant Human Growth Hormone (rhGH) Improved Renal Function in a Patient with Sheehan's Syndrome Associated with Chronic Renal Failure

BECAUSE GH plays a role in stimulating the glomerular filtration rate (GFR) [1, 2], GFR is increased in patients with acromegaly and rather decreased in patients with GH deficiency [3]. Chronic renal failure (CRF) is a progressive disease, and there is no effective drug available to improve renal dy...

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Published in:ENDOCRINE JOURNAL 1999, Vol.46 (suppl), p.S39-S42
Main Authors: MOTOI SOHMIYA, MASATERU NISHIKI, YUZURU KATO
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MASATERU NISHIKI
YUZURU KATO
description BECAUSE GH plays a role in stimulating the glomerular filtration rate (GFR) [1, 2], GFR is increased in patients with acromegaly and rather decreased in patients with GH deficiency [3]. Chronic renal failure (CRF) is a progressive disease, and there is no effective drug available to improve renal dysfunction, but it has not been reported whether GH replacement improves renal function in patients with GH deficiency associated with CRF. In the present study, we report for the first time that chronic GH replacement improved progressive renal dysfunction in a patient with Sheehan's syndrome accompanied by CRF. Case Report A 68-year-old woman was admitted to our hospital for further examination for severe anemia. She suffered from postpartum hemorrhage and took to bed for a month at the age of 20 years. Endocrinological data revealed decreased secretion of GH, ACTH, PRL, LH, FSH and ADH. Brain magnetic resonance imaging (MRI) revealed empty sella. Her detailed history and laboratory data led to a diagnosis of Sheehan's syndrome. The serum creatinine level was 1.3 mg/dl on the first admission. Replacement with adrenocortical hormone and thyroid hormone was started. The serum creatinine levels gradually increased to 2.4 mg/dl in 2 years in spite of appropriate diet therapy. Creatinine clearance for 24-h decreased to 25 ml/min. Edematous swelling appeared in the face and feet. She was admitted to our hospital for further examination of renal function.
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Chronic renal failure (CRF) is a progressive disease, and there is no effective drug available to improve renal dysfunction, but it has not been reported whether GH replacement improves renal function in patients with GH deficiency associated with CRF. In the present study, we report for the first time that chronic GH replacement improved progressive renal dysfunction in a patient with Sheehan's syndrome accompanied by CRF. Case Report A 68-year-old woman was admitted to our hospital for further examination for severe anemia. She suffered from postpartum hemorrhage and took to bed for a month at the age of 20 years. Endocrinological data revealed decreased secretion of GH, ACTH, PRL, LH, FSH and ADH. Brain magnetic resonance imaging (MRI) revealed empty sella. Her detailed history and laboratory data led to a diagnosis of Sheehan's syndrome. The serum creatinine level was 1.3 mg/dl on the first admission. Replacement with adrenocortical hormone and thyroid hormone was started. 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title Continuous Subcutaneous Infusion of Recombinant Human Growth Hormone (rhGH) Improved Renal Function in a Patient with Sheehan's Syndrome Associated with Chronic Renal Failure
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