Liver abnormalities during growth hormone treatment

Background: Occasional and transient increase in liver enzymes is reported during growth hormone (GH) treatment in girls with Turner syndrome (TS). Methods: Retrospectively, the specific role of GH treatment on liver and mu scular enzymes was evaluated in 78 patients (48 boys; age range 4.0-20.8 ye ars) affected by GH deficiency (GHD) who had been treated with GH for at le ast 1 year (range: 1-15 years). All patients had normal serum levels of liv er and muscular enzymes before GH therapy was started. Results: A clinically asymptomatic and mild increase in serum transaminase levels was observed in 6 of 78 patients with GHD during GH treatment; 3 (3. 8%) of the patients showed an isolated, transitory and self-limiting increa se in serum liver transaminase levels which was noticed 6 to 12 months afte r GH treatment was started, and normalized spontaneously within 3 to 6 mont hs, without stopping the therapy. Three additional patients showed a transi tory mild increase both in aspartate aminotransferase (AST) and creatine ph osphokinase (CK) which also normalized spontaneously within 3 to 6 months. The increase in transaminase levels was not related to the brand of GH prep arations nor to the dosage administered. Conclusions: A mild, transient, self-limiting increase in serum transaminas e may occur during GH treatment. Concomitant determination of CK serum leve ls may quickly differentiate muscular from hepatic hypertransaminasemia. Ex cept for persistent cases, this condition does not generally require furthe r investigations.