title: Estrogen supplementation for bone dematuration in young epileptic man treated with anticonvulsant therapy; a case report.
abstract: We encountered a young man treated with anticonvulsant therapy who had greatly reduced bone mineral density. An 18-year-old man was admitted to our hospital for shoulder pain and further evaluation of decreased bone mineral density. He had been treated with anticonvulsants, including phenytoin, phenobarbital, valproic acid and zonisamide for seizures. Although testosterone was found within the normal range for adult men, the serum estrogen concentration was below the detection limit (< 10 pg/ml) and his wrist epiphyses were not yet closed. After 10 months of treatment with the conjugated estrogen, both his height and weight showed improvement, while his bone mineral density and bone age were increased. These findings suggested that estrogen therapy had a significant effect on his skeletal growth and bone maturation in man. This is the first report showing the beneficial effect of estrogen supplementation in an epileptic man receiving treatment with anticonvulsants.
authors.affiliation: First Department of Medicine, Osaka Medical College, Takatsuki, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Yamano
authors.forename: S
authors.initials: S
authors.lastname: Sakane
authors.forename: J
authors.initials: J
authors.lastname: Takamatsu
authors.forename: N
authors.initials: N
authors.lastname: Ohsawa
mesh_terms: D000328:Adult; D000365:Age Determination by Skeleton; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001141:Aromatase / Q000235:genetics; D001827:Body Height / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D015519:Bone Density / Q000187:drug effects; D001846:Bone Development / Q000187:drug effects*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D004247:DNA / Q000032:analysis; D004827:Epilepsy / Q000188:drug therapy* / Q000503:physiopathology*; D004966:Estrogens, Conjugated (USP) / Q000627:therapeutic use*; D006225:Hand; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000188:drug therapy; D014953:Wrist
chemical_list: D000927:Anticonvulsants; D004966:Estrogens, Conjugated (USP); D004247:DNA; D001141:Aromatase