Cirrhosis in a child with hypothalamic syndrome and central precocious puberty treated with cyproterone acetate

Before the advent of gonadotropin-releasing-hormone analogues, cyproterone acetate (CPA) had been widely prescribed for the treatment of precocious pu berty. Although it is usually well tolerated, liver toxicity has been recog nized as a complication of its long-term use. We report the occurrence of c irrhosis in a 10-year-old boy with hypothalamic syndrome and precocious pub erty who was treated with CPA for over 50 months. Despite discontinuation o f the medication, the liver disease progressed. The patient died of sepsis and multiorgan failure at the age of 14 years. This is the first paediatric report of substantial liver damage and liver toxicity progressing to cirrh osis associated with CPA treatment. Conclusion Prolonged cyproterone acetate treatment may induce cirrhosis. Mo nitoring of liver-function both during treatment and for several months aft er discontinuation of therapy is recommended.