Oxandrolone increases final height in Turner syndrome.

In order to examine whether the anabolic steroid oxandrolone has any long-term effect on height in Turner syndrome, the short- and long-term effects were studied in a group of 35 individuals with the syndrome. At commencement of treatment, age range was 8.2-16 years (mean 12.9); oxandrolone dosage was 0.07-0.26 mg/kg per day (mean 0.14 mg/kg per day) and continued for 12 months-6 years (mean 33 months), ending at 12-18.5 years (mean 15.6 years). Height velocity increased significantly on therapy from 3.3 +/- 0.1 to 5.8 +/- 0.3 cm/year at 6 and 12 months, and maintained at 4.8 +/- 0.3 cm/year by two years (all P less than 0.001). Girls who were younger and whose bone age was delayed grew faster (P less than 0.001). Oxandrolone dose correlated with height velocity at 12 (r = 0.39, P less than 0.05) and 18 months (r = 0.31, P less than 0.05). Both height standard deviation score (SDS) and estimated mature height (EMH) increased significantly by the end of treatment (-0.31 +/- 0.2 to 0.45 +/- 0.2, and 140.4 +/- 1.1 cm to 144.4 +/- 1.1 cm respectively (both P less than 0.0001). In 23 patients who had completed growth at a mean age of 20.6 +/- 0.83 years, final height was 145.5 +/- 1.3 cm. This was not significantly different from EMH of 144.9 +/- 1.3 cm at the end of therapy, and based on a pre-treatment EMH of 140.5 +/- 1.3 cm, represented a mean height gain of 5 cm.(ABSTRACT TRUNCATED AT 250 WORDS)

Hypothalamic hypopituitarism following external radiotherapy for tumours distant from the adenohypophysis.

Three cases of panhypopituitarism and five of isolated growth hormone deficiency which occurred following previous external irradiation of tumours distant from the adenohypophysis are described. The hypothalamic pituitary region received between 2800 and 12 000 rads in each case, 1-9 years before endocrine deficiency was recognized. Evidence is presented that the site of damage is in the region of the hypothalamus rather than the pituitary gland itself. Individuals treated with X-ray therapy in whom the hypothalamic-pituitary region is exposed to irradiation would appear to be at risk of developing some degree of delayed hypothalamic-pituitary dysfunction.

Tall girls: a survey of 15 years of management and treatment.

In the past 15 years 450 girls have been seen because of concern about tall stature: 168 of them have been treated with stilbestrol to control the growth rate. Of the latter group 87 have been followed after treatment for a sufficiently long time to be sure growth had ceased and to provide the data for this report. At the onset of treatment the following data (mean values) were recorded: chronologic age, 13.0 years; skeletal age, 13.2 years; height, 172.9 cm; estimated mature height 180.2 cm; and growth potential, 7.3 cm. At the end of treatment data of interest (mean values) were: reduction in final height, 3.5 cm; duration of therapy, 2.1 years; amount of stilbestrol given, 2.3 gm; age of last visit, 17.6 years. Side effects were minimal, though two girls developed parovarian cysts that required surgery during treatment. Not included in the series of 87, one additional girl was seen with a serous cystadenoma of the ovary, and one girl developed superficial venous thrombosis of the calf. Long-term follow-up has revealed no late complications. It is concluded that estrogen can reduce significantly the growth rate of almost all tall girls, but treatment must be carried out under very careful supervision, bearing in mind possible side effects.