GROWTH-HORMONE IN COMBINATION WITH ANABOLIC-STEROIDS IN PATIENTS WITHTURNER SYNDROME - EFFECT ON BONE MATURATION AND FINAL HEIGHT

Twenty patients with Turner syndrome (CA 7.3-16.4 years) were treated with growth hormone (GH) alone (12-18 IU/m(2)/week) for 0.9-2.5 years. Subsequently, all patients received GH 18 IU/m(2)/week in combination with oxandrolone (Ox) (0.0625 mg/kg/day po) or low dose testosterone (5 mg every 2 weeks, i.m.). Ethinylestradiol (50 ng/kg/day po) was sta rted with a bone age of 12.5 ''years'', and the dose was increased ste pwise to 200 ng/kg/day during the next 18 months. Final height (FH) af ter 4-7.7 years of therapy was 152.9 +/- 3.5 cm (range 145.0-158.9 cm) . When compared to projected adult height (PAH) at start of therapy (1 43.7 +/- 4.0 range 137.5-151.6 cm), the estimated benefit from therapy (FH minus PAH) is 9.3 +/- 4.9 cm (range 1.4-21.4 cm). The wide range in individual responses may be due to over- or underestimation of PAH before therapy due to variation delay in bone age at start of therapy. FH did not differ between patients starting therapy before 15 years ( n = 9; 152.0 +/- 3.4 cm) and after the age of 11.5 years (n = 11; 153. 7 +/- 3.6 cm), due to the fact that a better short-term response to th erapy in the younger group of patients was compensated for by a faster progression in bone age. The good result in terms of final height may be due in part to the late start (BA 13.3 +/- 0.4 years; range 12.7-1 4.5 year) of estrogen therapy in low doses.