EFFECT OF CYPROTERONE ACETATE (CA) ON GROWTH AND ENDOCRINE FUNCTION IN PRECOCIOUS PUBERTY

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Abstract
Girls (16) with precocious puberty were studied. Following low dosage cyproterone acetate (CA) therapy (mean daily dosage 65 mg/m2 body surface area) a beneficial effect on growth and skeletal maturation was observed. During high dosage therapy (150 mg/m2 per day) endocrinological studies were performed in 10 of these patients. There was no significant difference in human growth hormone levels (insulin- and arginine-test), triiodothyronine and thyrotropin values (TRH[thyroliberin]-test) between patients and controls, thyroxine concentration was significantly increased. Basal prolactin levels and prolactin response to TRH was definitely elevated. Oral glucose load and Arg infusion resulted in a significantly enhanced insulin release. There was a significant reduction in basal lutropin levels and an increase in follitropin response to loliberin. Basal and diurnal plasma cortisol values were markedly reduced and the cortisol release due to ACTH injection, lysine-vasopressin (LVP) injection and insulin-hypoglycemia as well. A definite increase in basal ACTH levels was observed, during LVP- and insulin-hypoglycemia test ACTH concentrations were within or significantly above normal range. In the patients a primary adrenocortical insufficiency apparently due to CA treatment was evident.