Abstract
The appropriate age to initiate estrogen replacement therapy in adolescents with Turner syndrome (TS) is uncertain due to the potential for a deleterious effect on skeletal maturation and final height. We report results from the initial phase of a placebo-controlled, double-blind, multicenter trial of low dose oral ethinyl estradiol (EE) in TS subjects 12 to 14.99 years old, already receiving 0.05 mg/kg/d of growth hormone, and with Tanner breast stage 1 or 2 (mean 1.2) at enrollment. Fifty-two patients were randomized to 0, 25, or 100 ng/kg/d of EE and were evaluated every 6 months. Groups were identical for age (13.3 yr), bone age (10.8 yr), karyotype, growth rate (5.7 cm/yr) and height at enrollment. The following presents results at 12 months of therapy (mean ±SD):
The addition of EE during GH therapy in 12-15 yo girls with TS resulted in dose-dependent breast development and commensurate increases in skeletal maturation, which occurred in the absence of change in height velocity. Significant reduction in PAH could not be ascertained. We conclude that either 25 or 100 ng/k-d EE, with coordinate therapeutic risk and benefit, may be useful in inducing feminization in Turner syndome.
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Neelv, E., Rosenfeld, R. FIRST YEAR RESULTS Or A RANDOMIZED, PLACEBO-CONTROLLED TRIAL OF LOW DOSE ETHINYL ESTRADIOL FOR FEMINIZATION DURING GROWTH HORMONE THERAPY FOR TURNER SYNDROME. Pediatr Res 33 (Suppl 5), S89 (1993). https://doi.org/10.1203/00006450-199305001-00516
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DOI: https://doi.org/10.1203/00006450-199305001-00516