title: Marked increase of final height by long-term aromatase inhibition in a boy with idiopathic short stature.
abstract: Growth hormone (GH) is the most frequently used treatment in children with idiopathic short stature (ISS). Aromatase inhibitor (AI) therapy is still in an experimental state, and both final height (FH) and long-term efficacy data in ISS have not been published. We present a 14.5-year-old boy with ISS and a height of 142.7 cm [standard deviation score (SDS) -2.79]. Based on the baseline bone age (BA) of 13.5-14 years, his predicted adult height (PAH) by Bayley/Pinneau was 154 cm (SDS -3.77)-158.2 (SDS -3.15). After a 5-year letrozole monotherapy, FH was 169 cm (SDS -1.57) showing a height difference between PAH and FH from 10.8 to 15 cm. No permanent side effects of the medication have been observed. Both a transient occurrence and a spontaneous recovery of decreased bone mineral apparent density were seen, verified by dual-energy X-ray absorptiometry. Spinal magnetic resonance imaging revealed no vertebral abnormalities. All therapy might be an effective and low-cost alternative to the use of GH. Further controlled trials should prove efficacy and safety of long-term AI therapy in boys with ISS.
authors.affiliation: Department of Pediatrics and Adolescence Medicine, University Hospital, Freiburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Krebs
authors.forename: Olaf
authors.initials: O
authors.lastname: Moske-Eick
authors.forename: Jürgen
authors.initials: J
authors.lastname: Doerfer
authors.forename: Cordula
authors.initials: C
authors.lastname: Roemer-Pergher
authors.forename: Natascha
authors.initials: N
authors.lastname: van der Werf-Grohmann
authors.forename: Karl Otfried
authors.initials: KO
authors.lastname: Schwab
mesh_terms: D000293:Adolescent; D001141:Aromatase / Q000378:metabolism*; D047072:Aromatase Inhibitors / Q000627:therapeutic use*; D001827:Body Height / Q000187:drug effects*; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000187:drug effects; D006130:Growth Disorders / Q000188:drug therapy* / Q000201:enzymology*; D006801:Humans; D000077289:Letrozole; D008297:Male; D009570:Nitriles / Q000627:therapeutic use*; D011859:Radiography; D014230:Triazoles / Q000627:therapeutic use*
chemical_list: D047072:Aromatase Inhibitors; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole; D001141:Aromatase