Albrecht Andrea, Penger Theresa, Marx Michaela, Hirsch Karin, Dörr Helmuth G
Paediatric Endocrinology, Department of Paediatrics and Adolescent Medicine, University Hospital of Erlangen, Erlangen, Germany.
Paediatric Urology, Department of Urology, University Hospital of Erlangen, Erlangen, Germany.
J Pediatr Endocrinol Metab. 2018 Jan 26;31(1):21-24. doi: 10.1515/jpem-2017-0280.
Despite the fact that priming with sex steroids in prepubertal children before growth hormone (GH) provocative tests is recommended, there is an ongoing controversial discussion about the appropriate age of the children, the drug used for priming, the dose and the period between priming and the GH test. Interestingly, there is no discussion on the safety of this procedure. To date, only little data have been available on the possible side effects of priming with testosterone.
We analyzed the outcome in 188 short-statured prepubertal boys who had been primed with testosterone enanthate (n=136: 50 mg; n=51: 125 mg, and accidentally one boy with 250 mg) 7 days prior to the GH test. Serum testosterone levels were measured on the day of the GH test in 99 boys.
Overall, only five boys developed adverse side effects. Two boys (dose 125 mg) showed severe low-flow priapism and had to undergo decompression of the corpora cavernosa. One boy suffered from self-limiting priapism and testicular pain (dose 50 mg). Two patients reported testicular pain (each dose 50 mg). The single patient with 250 mg testosterone did not show any adverse effects. The total side effect rate was 2.7%. The serum testosterone levels of the boys with side effects were not different from the testosterone levels of the boys without any side effects.
Parents and patients should be informed about the possible side effects of priming with testosterone such as priapism and testicular pain. However, the overall side effect rate is low. We found no correlation between the outcome and the testosterone dose used and/or the level of serum testosterone.
尽管建议在青春期前儿童进行生长激素（GH）激发试验前使用性类固醇进行预处理，但关于儿童的合适年龄、用于预处理的药物、剂量以及预处理与GH试验之间的间隔时间，仍存在争议性的讨论。有趣的是，对于该程序的安全性却没有讨论。迄今为止，关于睾酮预处理可能的副作用仅有少量数据。
我们分析了188名青春期前身材矮小的男孩的结果，这些男孩在GH试验前7天接受了庚酸睾酮预处理（n = 136：50mg；n = 51：125mg，意外有一名男孩接受了250mg）。在GH试验当天对99名男孩测量了血清睾酮水平。
总体而言，只有5名男孩出现了不良副作用。两名男孩（剂量125mg）出现严重的低流量阴茎异常勃起，不得不进行海绵体减压。一名男孩患有自限性阴茎异常勃起和睾丸疼痛（剂量50mg）。两名患者报告有睾丸疼痛（均为剂量50mg）。接受250mg睾酮的唯一一名患者未显示任何不良反应。总副作用发生率为2.7%。出现副作用的男孩的血清睾酮水平与未出现任何副作用的男孩的睾酮水平没有差异。
应告知家长和患者睾酮预处理可能的副作用，如阴茎异常勃起和睾丸疼痛。然而，总体副作用发生率较低。我们发现结果与所用睾酮剂量和/或血清睾酮水平之间没有相关性。
