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      Long-Term Outcome of Male-Limited Gonadotropin-Independent Precocious Puberty

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          Long-term outcome of five new cases of male-limited precocious puberty (MPP) is reported. Three patients had positive family history. One patient was untreated; 2 boys received cyproterone acetate (2.0-3.6 mg/kg/daily) without clinical effects. Two patients were treated with ketoconazole (600 mg/daily); in 1, GnRH analogue therapy (Buserelin, 1,600 µg/day) was added after 6 months of effective ketoconazole treatment for development of central precocious puberty. The other patient did not develop central puberty under ketoconazole treatment and improved his predicted adult height from 172.4 to 181.1 cm. Four patients reached final height [B.A. (therapy cyproterone acetate): age 22.0 years, -2.0 SDS; B.G. (untreated): age 15.5 years, -1.7 SDS; M.M. (therapy cyproterone acetate): age 19.5 years, -1.6 SDS; M.F. (therapy ketoconazole plus GnRH analogue): age 21.3 years, -2.2 SDS]; three had reduced testicular volume (B.A.: -1.6/-1.6 SDS; B.G: -2.1/-2.1 SDS; M.F.: -2.4/-1.9 SDS); one (M.F.) showed oligospermia. We concluded that in MPP cyproterone acetate treatment did not improve final height; ketoconazole was effective in reducing testosterone secretion, but its real effect on final height cannot be determined; the timing of central puberty may be precocious, suggesting that an adjunctive GnRH analogue treatment may be needed. In some patients, testicular impairment may be present in young adulthood.

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          Author and article information

          Hormone Research in Paediatrics
          S. Karger AG
          10 December 2008
          : 48
          : 5
          : 235-239
          aEndocrine Unit, II Paediatric Clinic, University of Pisa; bEndocrine Unit, Paediatric Hospital ‘Regina Margherita’, Torino; cDiabetology, Paediatric Hospital ‘Bambino Gesù’, Palidoro, Roma, Italy
          185521 Horm Res 1997;48:235–239
          © 1997 S. Karger AG, Basel

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          Pages: 5
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