ELEVATION OF SERUM CREATINE-PHOSPHOKINASE DURING GROWTH-HORMONE TREATMENT IN PATIENTS WITH MULTIPLE PITUITARY-HORMONE DEFICIENCY

Serum creatine phosphokinase (s-CPK) increased to more than 500 U/1 in 5 out of 21 patients with growth hormone (GH) deficiency during the 2 years of treatment with biosynthetic GH. In three of these five patie nts, s-CPK had elevated gradually after the start of GH treatment and remained high in one patient except in the period when GH injection wa s interrupted, and gradually decreased in the other two patients durin g treatment. These three patients had complete GH deficiency associate d with multiple pituitary hormone deficiency due to pituitary stalk tr ansection. One of the remaining two patients had Noonan syndrome and h is s-CPK levels before therapy were relatively high. The fifth patient was a baseball athlete and the elevation of s-CPK seemed to be attrib utable to the strenuous exercise. Conclusion s-CPK increases significa ntly in a certain group of patients with GH deficiency during GH repla cement therapy, Measurement of s-CPK; is to be included in the follow up laboratory tests at least in the Ist treatment year to evaluate the potential hazardous effects of OH on muscle.