Abstract
In isolated growth hormone deficiency(i-GH-def) treated with GH, disproportinately advanced bony maturation occasionally followed in early to mid stage of puberty. We studied the effect of cyproterone acetate(CA) on accelerated sexual maturation associated with GH therapy for i-GH-def. Subjects were 7 patients, ages 14-19 years, and 2 females and 5 males. Four of them received 100mg/m2/day of CA for 1 to 3 years. In all, secondery sexual maturation occurred at 13 to 16 years of chronological age and at 9 to 13 years of bony age(BA). Serum testosterone(T) levels rapidly increased at 2nd grade of Tanner in male patients (T:530 -1560 ng/dl). In 3 males without CA treatment, bony maturation advanced rapidly from 2nd to 3rd grade of Tanner and a sensitive period for GH therapy was shortened. After a combined therapy of CA and GH, bony maturation decelerated and serum T levels fell off to prepubertal level (<30 ng/dl). Two females treated with CA exhibited the similar effect. Serum somatomedin-C responses to GH were similar before and after the CA therapy. A ratio of Δ height age/Δ BA for first one year after an appearance of secondary sexual characteristics was below 0.5 in 3 patients without CA treatment, but the ratio reached 1 or above in all of 4 treated with CA. In i-GH-def, CA suppressed the advance of Bony maturation and prolonged the effective period of GH therapy, and consequently may be able to make final height heigher than predicted adult height before CA treatment.
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Ohyama, K., Fujimoto, M. & Kato, K. 27 The Role of Cyproterone Acetate in the Treatment of Isolated Growth Hormone Deficiency. Pediatr Res 19, 608 (1985). https://doi.org/10.1203/00006450-198506000-00047
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DOI: https://doi.org/10.1203/00006450-198506000-00047