Testosterone induced priapism in two adolescents with sickle cell disease

Priapism is common in pubertal males with sickle cell disease, but the association between low-dose exogenous testosterone administration and priapism in such patients has not been well documented. Two adolescents with homozygous sickle cell disease (SCD) and delayed maturation with behavioral problems developed priapism about one week after receiving an intramuscular injection of testosterone enanthate. Neither had a previous history of priapism. We conclude that testosterone should not be administered to male patients with SCD because of the risk of inducing priapism and possible impotence.