03 December 2008
Thirty-four girls with precocious puberty (27 idiopathic, 6 cerebral, 1 McCune-Albright syndrome) were treated with cyproterone acetate (CPA) for 1.2-8.4 years (3.71 ± 0.31; mean ± SEM) at a daily dosage of 66-150 mg/m<sup>2</sup> (103.7 ± 6.2). The mean chronological age (CA) and bone age at the beginning of treatment were 5.99 ± 0.31 and 8.6 ± 0.39 years, respectively, and 9.78 ± 0.19 and 12.44 ± 0.22 years, respectively, at the end of therapy. At the last evaluation, mean CA was 14.23 ± 0.4 years, and 32 girls had reached final height. The control group consisted of 10 girls with idiopathic precocious puberty who, at their parents’ request, were not treated. Mean CA at the onset of pubertal signs was 6.05 ± 0.25 years. All patients had reached final height at the time of the last observation. There was no significant difference between final height of treated (152.43 ± 1.36 cm) and untreated (149.55 ± 1.99 cm) girls. Final height was significantly lower than target height in both treated (155.08 ± 0.92 cm; p < 0.025) and untreated (156.45 ± 1.29 cm; p < 0.0005) patients, but the mean height of treated patients is nearer to target height than that of untreated ones. A positive correlation was found between final height and target height both in treated (p < 0.005) and untreated (p < 0.05) patients. After the discontinuation of CPA treatment all girls resumed the progressive course of puberty. Menstruation was regular and normal in 27 cases and irregular in the remaining 7, of whom 4 showed additional hormonal and clinical evidence of polycystic ovarian disease (PCOD). Menses were regular in 8 and irregular in 2 untreated patients, of whom 1 also showed PCOD. It is concluded that CPA treatment slightly improved the statural growth of patients with precocious puberty. The altered gonadal function observed in adulthood in these patients is probably not due to CPA administration. A longer follow-up is needed in patients with central precocious puberty in order to detect the presence of PCOD.