Related Experiment Videos
Testosterone esters advance skeletal maturation more than growth in short boys with chronic renal failure and delayed
M W Van Steenbergen1, J M Wit, R A Donckerwolcke
1Department of Paediatrics, University Hospital for Children and Youth, University of Utrecht, The Netherlands.
Abstract:
Four young males with chronic renal failure and absent or stagnant puberty were treated with testosterone esters. Endocrine evaluation before therapy showed low plasma follicle stimulating hormone (FSH) levels and relatively high luteinizing hormone (LH). Following therapy skeletal maturation accelerated more than growth velocity, resulting in a lower predicted adult height. In three patients osteoporosis increased or rickets developed. Testosterone therapy was effective in developing sex characteristics, but endogenous pubertal development was not stimulated. Growth velocity was increased, but the effect on growth was more than outweighed by bone age acceleration.
Insights
Testosterone therapy in males with chronic renal failure and absent puberty accelerated bone age more than growth, leading to reduced adult height and worsening bone density. It did not stimulate natural pubertal development.
Area of Science:
- Pediatric Endocrinology
- Nephrology
- Adolescent Medicine
Background:
- Chronic renal failure (CRF) often presents with endocrine dysfunction, including delayed or absent puberty.
- Hormonal imbalances, such as low follicle-stimulating hormone (FSH) and high luteinizing hormone (LH), are common in these patients.
- Management of pubertal delay in CRF requires careful consideration of potential side effects.
Purpose of the Study:
- To evaluate the effects of testosterone ester therapy on growth, skeletal maturation, and pubertal development in young males with CRF.
- To assess the impact of testosterone on bone health in this patient population.
Main Methods:
- Four male patients with CRF and absent/stagnant puberty received testosterone ester treatment.
- Endocrine evaluations, including plasma FSH and LH levels, were performed before and during therapy.
- Growth velocity, skeletal maturation (bone age), and predicted adult height were monitored.
- Bone mineral density was assessed, noting changes in osteoporosis and rickets.
Main Results:
- Testosterone therapy effectively induced secondary sex characteristics.
- Endogenous pubertal development was not stimulated by the treatment.
- Growth velocity increased, but skeletal maturation accelerated disproportionately.
- Three patients experienced increased osteoporosis or developed rickets.
- Predicted adult height was reduced due to accelerated bone age.
Conclusions:
- Testosterone ester therapy can virilize males with CRF but does not initiate endogenous puberty.
- The accelerated bone age associated with testosterone treatment may limit final adult height.
- Potential for worsening bone metabolism (osteoporosis, rickets) necessitates careful monitoring in patients with CRF receiving testosterone.