FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 312:1023-1028 April 18, 1985 Number 16 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

Three boys 3.3 to 3.9 years old, who had precocious puberty that was unresponsive to an analogue of gonadotropin-releasing hormone, were treated with the antifungal agent ketoconazole for up to 12 months. Within 48 hours the serum testosterone concentration fell to normal in two boys and was significantly reduced in the third, paralleling major improvements in behavior. Reciprocal changes in serum levels of 17-hydroxyprogesterone suggested that C17-20 lyase was the principal site of drug action. Although there was evidence of a blunted cortisol reserve during the first week of treatment, the cortisol response to ACTH1-24 had returned to normal by one month of continuous treatment, and normal diurnal cortisol rhythm was preserved. No adverse clinical or biochemical side effects were noted during 9 to 12 months of continuing treatment. During that time, growth velocity was significantly reduced in all three boys, from a mean rate of 1.5 +/- 2.0 cm per year before treatment to 5.9 +/- 0.6 cm per year after ketoconazole therapy. There was a simultaneous retardation of the rate of skeletal maturation. The striking improvements in behavior were sustained for the duration of treatment. These preliminary data suggest that administration of ketoconazole may be a satisfactory treatment for precocious puberty in boys and possibly for other conditions characterized by androgen excess.

This article has been cited by other articles:

• Soriano-Guillen, L., Lahlou, N., Chauvet, G., Roger, M., Chaussain, J. L., Carel, J. C. (2005). Adult Height after Ketoconazole Treatment in Patients with Familial Male-Limited Precocious Puberty. J. Clin. Endocrinol. Metab. 90: 147-151 [Abstract] [Full Text]  
• Carel, J.-C., Lahlou, N., Roger, M., Chaussain, J. L. (2004). Precocious puberty and statural growth. Hum Reprod Update 10: 135-147 [Abstract] [Full Text]  
• Leschek, E. W., Jones, J., Barnes, K. M., Hill, S. C., Cutler, G. B. Jr. (1999). Six-Year Results of Spironolactone and Testolactone Treatment of Familial Male-Limited Precocious Puberty with Addition of Deslorelin after Central Puberty Onset. J. Clin. Endocrinol. Metab. 84: 175-178 [Abstract] [Full Text]  
• Clark, P. A., Clarke, W. L. (1995). Testotoxicosis: An Unusual Presentation and Novel Gene Mutation. CLIN PEDIATR 34: 271-274  
• Lee, P. A. (1994). Advances in the Management of Precocious Puberty. CLIN PEDIATR 33: 54-61