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Case Reports
. 2023;96(4):349-355.
doi: 10.1159/000526617. Epub 2022 Aug 24.

Can GH Therapy Worsen a Clinically Silent Chiari Malformation? A Case Report and Systematic Literature Review

Egidio Candela  1   2 , Emanuele La Corte  3   4 , Stefano Zucchini  2 , Mariella Lefosse  3 , Francesco Toni  5 , Mino Zucchelli  3
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Free article
Case Reports

Can GH Therapy Worsen a Clinically Silent Chiari Malformation? A Case Report and Systematic Literature Review

Egidio Candela et al. Horm Res Paediatr. 2023.
Free article

Abstract

Background: The link between the effects of recombinant human growth hormone (rhGH) therapy in patients with growth hormone deficiency (GHD) and Chiari malformation type I (CM-1) is controversial.

Summary: We report the case of a patient with an unusual association of GHD due to ectopic posterior pituitary and CM-1. Our patient developed a headache and worsening of CM-1 after the initiation of rhGH therapy. Following an atlo-occipital decompression surgery, the patient was able to resume therapy with a marked growth improvement. Based on this observation, we provide a systematic review of the current literature about these two pathologies.

Key messages: A careful follow-up of all patients with CM-1 treated with GH is mandatory, paying particular attention to the appearance of any neurological signs and symptoms.

Keywords: Atlo-occipital decompression surgery; Chiari type 1 malformation; GH therapy; Systematic literature review.

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