Aim: Differentiating idiopathic hypogonadotrophic hypogonadism from extreme maturational delay can be difficult, so most boys receive testosterone (T) replacement until the diagnosis becomes clear. Standard 3 month T therapy for maturational delay does not diminish adult stature, so we set out to determine whether T treatment of greater than 6 months duration would have an adverse effect on final height (FH) in boys with the eventual diagnosis of extreme maturational delay.
Patients and methods: 18 boys demonstrating spontaneous testicular growth and progression in puberty were selected from the Regional Paediatric Endocrine Database. All had full auxology, pubertal staging and mid parental height (MPH) recorded. All boys received testosterone (oral or IM) in physiological replacement doses over 6-35 months until it was stopped when spontaneous testicular growth occurred. Auxology was compared with national standards.
Results: 6/18 had reached FH mean 174.5 cm (-0.4 SDS), all within the Target Centile Range (TCR), MPHSDS - FHSDS range 0.2 to -1.0. Twelve boys were still growing but in 8 their last recorded height was within the TCR, and the remaining 4 were on target to reach this. In those who had stopped growing the correlation between SDS deficit and total time on T was poor (r = 0.27, p = 0.66).
Conclusion: This preliminary analysis suggests that longer term T therapy does not appear to adversely affect the FH in boys with extreme maturational delay. FH outcome is not a function of the duration of T therapy if a physiological replacement regimen is followed.
22 - 24 Mar 2004
British Endocrine Societies