Are there any individual differences in the possible adverse effects and side effects of growth hormone?
Professor: Yes. All drug reactions are firstly related to the drug itself, and then to individual differences. We require doctors to keep good records before using growth hormone, to carefully check whether the child has scoliosis, etc., and to do basic routine biochemical tests. Also, considering that groups and individuals are different and everyone has a risk of developing tumors, it is important to give the child the appropriate examination and understand his or her family history of the disease.
What tests should be done for children before using growth hormone for the first month and then every three months? Professor: The tests include preventive tests and etiological tests. Preventive tests include basic blood and urine tests, liver and kidney functions, blood sugar, whether there is a multi-pituitary hormone deficiency, and tumor marker tests (which can alert to the occurrence of tumors). Some children on growth hormone develop hematuria or proteinuria. Without prior basic testing, the doctor cannot tell whether the patient has a pre-existing underlying condition or an adverse reaction to the medication. Etiology testing includes an MRI of the pituitary gland, if necessary. Some growth hormone deficiencies arise etiologically from pituitary hypoplasia or, in rare cases, pituitary growth hormone deficiency caused by tumor compression. This can be detected by MRI. How often should growth hormone injections be rechecked and what are the items included? Professor:Most of the diseases that are treated with growth hormone are not temporary diseases. In other words, unlike colds and flu, which have stages and can be cured in a few days or weeks, they often require long-term treatment. This also requires regular review and follow-up. Generally, we require a routine checkup in the first month after using growth hormone, and then a review every three months after that.
The first is to monitor the effectiveness of the treatment and to monitor the child’s physical development and height changes after using the medicine. The second is to monitor the results of various laboratory tests to see if they show any adverse reactions or side effects.
If a child has a pseudo-headache or other brain symptoms, or during a routine review, should I also check the MRI?
Professor:Generally, it is not necessary. This diagnosis is mostly a one-time procedure to look at the development of the hypophysis to identify congenital intracranial malformations and pituitary hypoplasia, or to rule out pituitary abnormalities caused by secondary tumor compression or intracranial hemorrhage injury. And the child has already had MRI before the medication, there is no need to repeat it after the diagnosis is confirmed. Moreover, pseudo headache or pseudo brain tumor is a known side effect of the medication. We will stop the medication for a week first, and if the symptoms recover completely, it means it is a medication problem. Most children who stop the medication for a period of time and then use it again are able to continue treatment without having headache symptoms a second time.
Is it true that when a child has an adverse reaction to medication, he or she is first advised to stop the medication for a period of time, and if the symptoms disappear, it means it is related to the medication?
Professor: Yes. Parents should read the drug instructions carefully before giving medication to their children. If there is an adverse reaction after using the drug, you should also check the drug instructions, which are all prompted. For some small, common adverse reactions, you can stop the drug for observation. For example, if blood glucose rises, you can stop the drug to see how blood glucose recovers. Before using the medication, special emphasis should be placed on finding out if there is any family history of diabetes or oncological disease. We must tell parents that if there are these conditions in the family, they must be cautious in the process of medication use and insist on regular rechecking. It is not possible to use growth hormone for six months or a year without a review, which is irresponsible to the child.
How long is it appropriate to stop the medication?
Professor: This varies from person to person and from symptom to symptom. It is recommended that all discontinuation and resumption of medication be monitored by a doctor and that parents do not take the initiative.