Hyperparathyroidism during growth hormone treatment: a role for puberty?

We describe three adolescent patients on chronic hemodialysis with a pubert al growth spurt who developed severe hyperparathyroidism during recombinant human growth hormone treatment. Parathyroid hormone levels were raised in parallel with the increase in linear growth in all patients. In two patient s, hyperparathyroidism was successfully controlled with an increase in calc itriol dosage. In the third patient, growth hormone had to be withdrawn. We discuss the possibility that puberty is a risk factor for the development of hyperparathyroidism during growth hormone therapy.