Aromatase inhibitor plus growth hormone can optimize height
Katherine Hawton, M.B.B.S., from the Bristol Royal Hospital for Children in the United Kingdom, and colleagues describe a 6-year-old patient with CAH who had been suboptimally treated and presented with precocious puberty, hypertension, tall stature, advanced bone age, and a predicted final height of 150 cm.
The researchers confirmed a diagnosis of 11β-hydroxylase deficiency in hormonal profiles and genetic analysis. In an attempt to optimize the patient's growth, he was started on growth hormone and a third-generation aromatase inhibitor, anastrozole, in addition to glucocorticoid replacement. The patient's growth rate improved significantly after initiation of treatment and his bone age advancement slowed. The patient reached a final height of 177.5 cm, which was 11.5 cm above his mid-parental height.
"This patient is only the second reported case of the use of an aromatase inhibitor in combination with growth hormone to optimize height in 11β-hydroxylase-deficient CAH," the authors write. "This novel treatment proved to be highly efficacious, with no adverse effects."
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