Background: The link between the effects of recombinant human growth hormone (rhGH) therapy in patient 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 growth hormone deficiency (GHD) due to ectopic posterior pituitary and Chiari malformation type I (CM-1). Our patient developed headache and worsening of CM-1 after 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.


中文翻译：

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GH 治疗会使临床无症状的 Chiari 畸形恶化吗？病例报告和系统文献综述。

背景：重组人生长激素 (rhGH) 治疗对生长激素缺乏 (GHD) 患者和 I 型 Chiari 畸形 (CM-1) 的影响之间的联系存在争议。摘要：我们报告了一例由于异位垂体后叶和 I 型 Chiari 畸形 (CM-1) 导致生长激素缺乏 (GHD) 异常相关的患者病例。该患者在开始 rhGH 治疗后出现头痛和 CM-1 恶化。寰枕减压手术后，患者能够恢复治疗，生长明显改善。基于这一观察，我们对有关这两种病理学的当前文献进行了系统回顾。关键信息：必须对所有接受 GH 治疗的 CM-1 患者进行仔细随访，特别注意任何神经系统体征和症状的出现。