Brachet Cecile, Heinrichs Claudine
Pediatric Endocrinology Unit, Hôpital Universitaire des Enfants Reine Fabiola-ULB, Brussels, Belgium.
J Pediatr Endocrinol Metab. 2012;25(7-8):757-60. doi: 10.1515/jpem-2012-0067.
Over the last 10 years, several children, fetuses and women have been reported to be virilized through interpersonal transfer of testosterone (T) gel used by fathers or partners. Long-term exposure to androgens in children, such as in poorly controlled congenital adrenal hyperplasia, is known to promote central precocious puberty.
Clinical case report.
We report on a 5-year-old boy who developed central precocious puberty after long-term (starting prenatally) exposure to testosterone through interpersonal transfer of T gel used by his father. We also report on another case illustrating that the recommended precautions are not sufficient to avoid interpersonal transfer of T gel among household contacts. Plasma testosterone levels and history-taking revealed the cause of virilisation and the testosterone contamination source in both cases. Given the increased testicular volume and persisting testosterone elevation after cessation of gel use in the first patient, a GnRH test was carried out and confirmed central precocious puberty.
This is the first report of a boy with central precocious puberty occurring after long-term (starting prenatally) exposure to testosterone through the interpersonal transfer of Tgel. This report questions whether central precocious puberty constitutes a long-term side effect of testosterone exposure in childhood through T gel use by a household contact.
在过去10年里，有报道称多名儿童、胎儿及女性因父亲或伴侣使用的睾酮（T）凝胶发生人际转移而出现男性化。已知儿童长期暴露于雄激素，如在控制不佳的先天性肾上腺皮质增生症中，会促进中枢性性早熟。
临床病例报告。
我们报告了一名5岁男孩，他在通过人际转移接触其父亲使用的T凝胶而长期（从产前开始）暴露于睾酮后出现了中枢性性早熟。我们还报告了另一例病例，说明推荐的预防措施不足以避免T凝胶在家庭接触者之间发生人际转移。血浆睾酮水平和病史询问揭示了两例病例中男性化的原因及睾酮污染来源。鉴于首例患者在停止使用凝胶后睾丸体积增大且睾酮持续升高，进行了促性腺激素释放激素（GnRH）试验并确诊为中枢性性早熟。
这是首例关于男孩因通过T凝胶的人际转移长期（从产前开始）暴露于睾酮后发生中枢性性早熟的报告。本报告质疑中枢性性早熟是否构成儿童期因家庭接触者使用T凝胶而暴露于睾酮的长期副作用。
