Central Precocious Puberty as a Complication of Therapy with Adrenocorticotropin (ACTH) and an Aromatase Inhibitor for Refractory Nephrotic Syndrome
Glucocorticoids are typically prescribed for the treatment of idiopathic nephrotic syndrome of childhood. In selected patients with refractory focal segmental glomuerulosclerosis (FSGS), adrenocorticotropin (ACTH) can be used to induce remission and decrease the progression of the disease. We report...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2019/1624274 |
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| author | Sungeeta Agrawal Robert Gensure Lawrence Milner Julie Nicoletta Abdollah Sadeghi-Nejad |
| author_facet | Sungeeta Agrawal Robert Gensure Lawrence Milner Julie Nicoletta Abdollah Sadeghi-Nejad |
| author_sort | Sungeeta Agrawal |
| collection | DOAJ |
| description | Glucocorticoids are typically prescribed for the treatment of idiopathic nephrotic syndrome of childhood. In selected patients with refractory focal segmental glomuerulosclerosis (FSGS), adrenocorticotropin (ACTH) can be used to induce remission and decrease the progression of the disease. We report a 6 8/12-year-old girl with recurrent proteinuria, resistant to standard immunotherapy. She underwent related renal transplant but again developed proteinuria and was started on ACTH. She subsequently developed peripheral precocious puberty (PPP), presumably from peripheral aromatization of adrenal androgens. She was started on an aromatase inhibitor, and her ACTH dose was slowly decreased. She then developed central precocious puberty (CPP). We hypothesize that treatment of her peripheral precocious puberty with an aromatase inhibitor may have triggered central precocious puberty. |
| format | Article |
| id | doaj-art-5a2b14a074004afa9b193d3ab48311b9 |
| institution | Kabale University |
| issn | 2090-6803 2090-6811 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-5a2b14a074004afa9b193d3ab48311b92025-02-03T01:31:32ZengWileyCase Reports in Pediatrics2090-68032090-68112019-01-01201910.1155/2019/16242741624274Central Precocious Puberty as a Complication of Therapy with Adrenocorticotropin (ACTH) and an Aromatase Inhibitor for Refractory Nephrotic SyndromeSungeeta Agrawal0Robert Gensure1Lawrence Milner2Julie Nicoletta3Abdollah Sadeghi-Nejad4Division of Pediatric Endocrinology, Floating Hospital for Children, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USADivision of Pediatric Endocrinology, Floating Hospital for Children, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USADivision of Pediatric Nephrology, Floating Hospital for Children, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USADivision of Pediatric Nephrology, Floating Hospital for Children, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USADivision of Pediatric Endocrinology, Floating Hospital for Children, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USAGlucocorticoids are typically prescribed for the treatment of idiopathic nephrotic syndrome of childhood. In selected patients with refractory focal segmental glomuerulosclerosis (FSGS), adrenocorticotropin (ACTH) can be used to induce remission and decrease the progression of the disease. We report a 6 8/12-year-old girl with recurrent proteinuria, resistant to standard immunotherapy. She underwent related renal transplant but again developed proteinuria and was started on ACTH. She subsequently developed peripheral precocious puberty (PPP), presumably from peripheral aromatization of adrenal androgens. She was started on an aromatase inhibitor, and her ACTH dose was slowly decreased. She then developed central precocious puberty (CPP). We hypothesize that treatment of her peripheral precocious puberty with an aromatase inhibitor may have triggered central precocious puberty.http://dx.doi.org/10.1155/2019/1624274 |
| spellingShingle | Sungeeta Agrawal Robert Gensure Lawrence Milner Julie Nicoletta Abdollah Sadeghi-Nejad Central Precocious Puberty as a Complication of Therapy with Adrenocorticotropin (ACTH) and an Aromatase Inhibitor for Refractory Nephrotic Syndrome Case Reports in Pediatrics |
| title | Central Precocious Puberty as a Complication of Therapy with Adrenocorticotropin (ACTH) and an Aromatase Inhibitor for Refractory Nephrotic Syndrome |
| title_full | Central Precocious Puberty as a Complication of Therapy with Adrenocorticotropin (ACTH) and an Aromatase Inhibitor for Refractory Nephrotic Syndrome |
| title_fullStr | Central Precocious Puberty as a Complication of Therapy with Adrenocorticotropin (ACTH) and an Aromatase Inhibitor for Refractory Nephrotic Syndrome |
| title_full_unstemmed | Central Precocious Puberty as a Complication of Therapy with Adrenocorticotropin (ACTH) and an Aromatase Inhibitor for Refractory Nephrotic Syndrome |
| title_short | Central Precocious Puberty as a Complication of Therapy with Adrenocorticotropin (ACTH) and an Aromatase Inhibitor for Refractory Nephrotic Syndrome |
| title_sort | central precocious puberty as a complication of therapy with adrenocorticotropin acth and an aromatase inhibitor for refractory nephrotic syndrome |
| url | http://dx.doi.org/10.1155/2019/1624274 |
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