FINAL HEIGHT OUTCOME IN GIRLS WITH TURNER-SYNDROME TREATED WITH A COMBINATION OF LOW-DOSE ESTROGEN AND OXANDROLONE

Final stature in girls with Turner syndrome treated with combination o f low dose oestrogen and oxandrolone. Nineteen prepubertal girls with Turner syndrome (mean age 10.9 years, range, 8.9-14.2 years) were rand omly assigned to receive either oxandrolone (0.05 mg/kg/day) or ethiny loestradiol (40 ng/kg/day) for 1 year. Subsequently the alternate ther apy was added and the combination given until attainment of final heig ht. Ethinyloestradiol was gradually increased at the age of 12.5 years in order to induce secondary sexual characteristics. The duration of treatment was a mean of 5.2 years (range, 3-7 years) when the Ist year of monotherapy was included. Therapy produced a sustained acceleratio n in growth rate for a duration of 4 years and eventually has resulted in an increment of mean adult height of 3 cm relative to pre-treatmen t projected height with mean values of 146.5 cm versus 143.5 cm respec tively. The moderate side-effects observed did not cause any of the gi rls to discontinue treatment. Nevertheless, amelioration of adult heig ht appears to be modest, notably in comparison to published data of gr owth hormone treatment and 4 girls had a decrease in final height pred iction. Conclusion. Combination of low dose of oxandrolone and oestrog en may have a moderate but positive impact on final height in girls wi th Turner syndrome. However, some girls do worse than predicted in ter m of final height using this regimen. Oestrogen therapy started at low dose around the age of 10 years and increased gradually at approximat ely 12.5 years to induce secondary sexual characteristics does not hav e a deleterious effect on adult height in Turner syndrome. In summary, low dose oxandrolone-oestrogen treatment was found to accelerate the tempo of growth in girls with Turner syndrome,but did not appear to ha ve a consistent effect on final height.