title: Cirrhosis in a child with hypothalamic syndrome and central precocious puberty treated with cyproterone acetate.
abstract: Before the advent of gonadotropin-releasing-hormone analogues, cyproterone acetate (CPA) had been widely prescribed for the treatment of precocious puberty. Although it is usually well tolerated, liver toxicity has been recognized as a complication of its long-term use. We report the occurrence of cirrhosis in a 10-year-old boy with hypothalamic syndrome and precocious puberty who was treated with CPA for over 50 months. Despite discontinuation of 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 cirrhosis associated with CPA treatment.
  
  
  CONCLUSIONS
  Prolonged cyproterone acetate treatment may induce cirrhosis. Monitoring of liver function both during treatment and for several months after discontinuation of therapy is recommended.
authors.affiliation: Department of Paediatrics B, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Petah Tiqva, Israel.
authors.forename: B Z
authors.initials: BZ
authors.lastname: Garty
authors.forename: G
authors.initials: G
authors.lastname: Dinari
authors.forename: A
authors.initials: A
authors.lastname: Gellvan
authors.forename: R
authors.initials: R
authors.lastname: Kauli
mesh_terms: D000293:Adolescent; D056486:Chemical and Drug Induced Liver Injury / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D002648:Child; D017373:Cyproterone Acetate / Q000009:adverse effects* / Q000627:therapeutic use; D017809:Fatal Outcome; D006801:Humans; D007027:Hypothalamic Diseases / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D008103:Liver Cirrhosis / Q000139:chemically induced* / Q000150:complications / Q000175:diagnosis; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D045167:Progesterone Congeners / Q000009:adverse effects* / Q000627:therapeutic use; D011629:Puberty, Precocious / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D018805:Sepsis / Q000209:etiology; D013577:Syndrome
chemical_list: D045167:Progesterone Congeners; D017373:Cyproterone Acetate