Krebs Andreas, Moske-Eick Olaf, Doerfer Jürgen, Roemer-Pergher Cordula, van der Werf-Grohmann Natascha, Schwab Karl Otfried
Department of Pediatrics and Adolescence Medicine, University Hospital, Freiburg, Germany.
J Pediatr Endocrinol Metab. 2012;25(5-6):581-5. doi: 10.1515/jpem-2011-0435.
Growth hormone (GH) is the most frequently used treatment in children with idiopathic short stature (ISS). Aromatase inhibitor (AI) therapy is still in an experimental state, and both final height (FH) and long-term efficacy data in ISS have not been published. We present a 14.5-year-old boy with ISS and a height of 142.7 cm [standard deviation score (SDS) -2.79]. Based on the baseline bone age (BA) of 13.5-14 years, his predicted adult height (PAH) by Bayley/Pinneau was 154 cm (SDS -3.77)-158.2 (SDS -3.15). After a 5-year letrozole monotherapy, FH was 169 cm (SDS -1.57) showing a height difference between PAH and FH from 10.8 to 15 cm. No permanent side effects of the medication have been observed. Both a transient occurrence and a spontaneous recovery of decreased bone mineral apparent density were seen, verified by dual-energy X-ray absorptiometry. Spinal magnetic resonance imaging revealed no vertebral abnormalities. All therapy might be an effective and low-cost alternative to the use of GH. Further controlled trials should prove efficacy and safety of long-term AI therapy in boys with ISS.
生长激素（GH）是治疗特发性身材矮小（ISS）儿童最常用的方法。芳香化酶抑制剂（AI）疗法仍处于实验阶段，ISS患者的最终身高（FH）和长期疗效数据均未公布。我们报告一名14.5岁的ISS男孩，身高142.7厘米[标准差评分（SDS）-2.79]。根据13.5至14岁的基线骨龄（BA），通过贝利/平诺方法预测他的成人身高（PAH）为154厘米（SDS -3.77）至158.2厘米（SDS -3.15）。经过5年的来曲唑单药治疗，FH为169厘米（SDS -1.57），显示PAH与FH之间的身高差异为10.8至15厘米。未观察到药物的永久性副作用。通过双能X线吸收法证实，出现了骨矿物质表观密度降低的短暂情况且自行恢复。脊柱磁共振成像未显示椎体异常。所有治疗可能是使用GH的一种有效且低成本的替代方法。进一步的对照试验应证明长期AI疗法对ISS男孩的疗效和安全性。
