I am an endocrinology intern from india,the case is a 12yrs 8month old boy presents with concern for short stature and puberty advancement,(voice broken at 11yrs, axillary hair 111/2 yrs), when comparing with the peers. ht 145cm/wt38.5,axillary hair stage 3/pubic hair stage 3/testis 20ml on both sides/phallus length 8cm/bone age 13-14yrs,
Hormone profiles thyroid functions normal , prolactin normal,17OHP normal,LH/FSH are in pubertal range. sr.testosterone slightly lower than the normal range.
- his concern is how tall he will grow? (mother and father ht 152cm/155cm)
- Is there any way his mild advancement in puberty can be slowed or delayed?
- management? Dr.Arun Kannan, Amrita Institute of Medical Sciences, Cochin, India
I believe that your patient had a normal, or sligthly anticipated pubertal development. Despite a testicular volume of 20cc, his predicted height with a bone age of 13.5 yrs is 160cm (BA 13: 165 cm; BA 14:156 cm) which is exactly the same as his target height that is 160 cm. I don't think is worth doing anything, and I believe that slowing the pubertal process at this point might either harm his growth pattern by eventually stopping his pubertal spurt, if he he has not been through it yet, or just be useless. I would just continue a clinical follow-up reassuring him that he will probably achieve his father's height. Keep me updated on your patient's follow-up.
Lucia Ghizzoni M.D., Ph.D