Combined Treatment With Leuprolide Acetate and Burosumab in X-linked Hypophosphatemia and Precocious Puberty: A Therapeutic Response
Background/Objective: Individuals with X-linked hypophosphatemia (XLH) generally experience normal puberty. However, the prevalence of central precocious puberty (CPP) in patients with XLH seems to be similar to that of the general population, and CPP may similarly impact their predicted final heigh...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | AACE Clinical Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2376060524001020 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841528001268809728 |
|---|---|
| author | Gustavo Tempone Cardoso Penna, MS Carolina Costa Figueiredo, MD, MSc Nara Michelle de Araújo Evangelista, MD, MSc Vânia de Fátima Tonetto Fernandes, MD, PhD Patricia Salmona, MD Guido de Paula Colares Neto, MD, PhD |
| author_facet | Gustavo Tempone Cardoso Penna, MS Carolina Costa Figueiredo, MD, MSc Nara Michelle de Araújo Evangelista, MD, MSc Vânia de Fátima Tonetto Fernandes, MD, PhD Patricia Salmona, MD Guido de Paula Colares Neto, MD, PhD |
| author_sort | Gustavo Tempone Cardoso Penna, MS |
| collection | DOAJ |
| description | Background/Objective: Individuals with X-linked hypophosphatemia (XLH) generally experience normal puberty. However, the prevalence of central precocious puberty (CPP) in patients with XLH seems to be similar to that of the general population, and CPP may similarly impact their predicted final height. Case Report: A female patient was diagnosed with XLH at 3 years old and received regular calcitriol and sodium-potassium phosphate treatment until age six. During this period, she showed increased growth velocity and improved height Z-score (from −2.38 SD to −1.95 SD). At 6 years and 11 months, she was diagnosed with idiopathic CPP, marked by thelarche, a growth spurt, and advanced bone age, resulting in a decreased predicted final height Z-score. She began pubertal blockade with leuprolide acetate and transitioned from conventional XLH treatment to burosumab. The combination of these treatments led to stabilized bone age, normalized growth velocity, and improved final height prediction without side effects or negative impacts on bone health during treatment. Discussion: Although the prevalence of CPP in XLH patients has not been extensively studied, CPP in XLH may affect final height and worsen rickets by increasing mineral demands during growth spurts. Thus, CPP can be treated in patients with XLH, who may have compromised height outcomes, using synthetic gonadotropin-releasing hormone analogs. Conclusion: In the described XLH patient with CPP, the combined use of gonadotropin-releasing hormone analogs and burosumab was a safe strategy to stabilize pubertal progression and bone age, minimize anthropometric loss, and avoid exacerbating bone deformities. |
| format | Article |
| id | doaj-art-8ecc9479473b40d198a60102b9dea953 |
| institution | Kabale University |
| issn | 2376-0605 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | AACE Clinical Case Reports |
| spelling | doaj-art-8ecc9479473b40d198a60102b9dea9532025-01-15T04:11:44ZengElsevierAACE Clinical Case Reports2376-06052025-01-011111823Combined Treatment With Leuprolide Acetate and Burosumab in X-linked Hypophosphatemia and Precocious Puberty: A Therapeutic ResponseGustavo Tempone Cardoso Penna, MS0Carolina Costa Figueiredo, MD, MSc1Nara Michelle de Araújo Evangelista, MD, MSc2Vânia de Fátima Tonetto Fernandes, MD, PhD3Patricia Salmona, MD4Guido de Paula Colares Neto, MD, PhD5Centro Universitário São Camilo, Faculdade de Medicina. Avenida Nazaré, São Paulo, São Paulo, BrasilHospital Infantil Darcy Vargas. Rua Dr. Seráfico de Assis Carvalho, São Paulo, São Paulo, BrasilHospital Infantil Darcy Vargas. Rua Dr. Seráfico de Assis Carvalho, São Paulo, São Paulo, BrasilCentro Universitário São Camilo, Faculdade de Medicina. Avenida Nazaré, São Paulo, São Paulo, BrasilHospital Infantil Darcy Vargas. Rua Dr. Seráfico de Assis Carvalho, São Paulo, São Paulo, BrasilCentro Universitário São Camilo, Faculdade de Medicina. Avenida Nazaré, São Paulo, São Paulo, Brasil; Address correspondence to Dr Guido de Paula Colares Neto, Faculdade de Medicina. Centro Universitário São Camilo, Avenida Nazaré, 1501 CEP: 04263-200, São Paulo, São Paulo, Brasil.Background/Objective: Individuals with X-linked hypophosphatemia (XLH) generally experience normal puberty. However, the prevalence of central precocious puberty (CPP) in patients with XLH seems to be similar to that of the general population, and CPP may similarly impact their predicted final height. Case Report: A female patient was diagnosed with XLH at 3 years old and received regular calcitriol and sodium-potassium phosphate treatment until age six. During this period, she showed increased growth velocity and improved height Z-score (from −2.38 SD to −1.95 SD). At 6 years and 11 months, she was diagnosed with idiopathic CPP, marked by thelarche, a growth spurt, and advanced bone age, resulting in a decreased predicted final height Z-score. She began pubertal blockade with leuprolide acetate and transitioned from conventional XLH treatment to burosumab. The combination of these treatments led to stabilized bone age, normalized growth velocity, and improved final height prediction without side effects or negative impacts on bone health during treatment. Discussion: Although the prevalence of CPP in XLH patients has not been extensively studied, CPP in XLH may affect final height and worsen rickets by increasing mineral demands during growth spurts. Thus, CPP can be treated in patients with XLH, who may have compromised height outcomes, using synthetic gonadotropin-releasing hormone analogs. Conclusion: In the described XLH patient with CPP, the combined use of gonadotropin-releasing hormone analogs and burosumab was a safe strategy to stabilize pubertal progression and bone age, minimize anthropometric loss, and avoid exacerbating bone deformities.http://www.sciencedirect.com/science/article/pii/S2376060524001020burosumabcentral precocious pubertyleuprolide acetateX-linked hypophosphatemia |
| spellingShingle | Gustavo Tempone Cardoso Penna, MS Carolina Costa Figueiredo, MD, MSc Nara Michelle de Araújo Evangelista, MD, MSc Vânia de Fátima Tonetto Fernandes, MD, PhD Patricia Salmona, MD Guido de Paula Colares Neto, MD, PhD Combined Treatment With Leuprolide Acetate and Burosumab in X-linked Hypophosphatemia and Precocious Puberty: A Therapeutic Response AACE Clinical Case Reports burosumab central precocious puberty leuprolide acetate X-linked hypophosphatemia |
| title | Combined Treatment With Leuprolide Acetate and Burosumab in X-linked Hypophosphatemia and Precocious Puberty: A Therapeutic Response |
| title_full | Combined Treatment With Leuprolide Acetate and Burosumab in X-linked Hypophosphatemia and Precocious Puberty: A Therapeutic Response |
| title_fullStr | Combined Treatment With Leuprolide Acetate and Burosumab in X-linked Hypophosphatemia and Precocious Puberty: A Therapeutic Response |
| title_full_unstemmed | Combined Treatment With Leuprolide Acetate and Burosumab in X-linked Hypophosphatemia and Precocious Puberty: A Therapeutic Response |
| title_short | Combined Treatment With Leuprolide Acetate and Burosumab in X-linked Hypophosphatemia and Precocious Puberty: A Therapeutic Response |
| title_sort | combined treatment with leuprolide acetate and burosumab in x linked hypophosphatemia and precocious puberty a therapeutic response |
| topic | burosumab central precocious puberty leuprolide acetate X-linked hypophosphatemia |
| url | http://www.sciencedirect.com/science/article/pii/S2376060524001020 |
| work_keys_str_mv | AT gustavotemponecardosopennams combinedtreatmentwithleuprolideacetateandburosumabinxlinkedhypophosphatemiaandprecociouspubertyatherapeuticresponse AT carolinacostafigueiredomdmsc combinedtreatmentwithleuprolideacetateandburosumabinxlinkedhypophosphatemiaandprecociouspubertyatherapeuticresponse AT naramichelledearaujoevangelistamdmsc combinedtreatmentwithleuprolideacetateandburosumabinxlinkedhypophosphatemiaandprecociouspubertyatherapeuticresponse AT vaniadefatimatonettofernandesmdphd combinedtreatmentwithleuprolideacetateandburosumabinxlinkedhypophosphatemiaandprecociouspubertyatherapeuticresponse AT patriciasalmonamd combinedtreatmentwithleuprolideacetateandburosumabinxlinkedhypophosphatemiaandprecociouspubertyatherapeuticresponse AT guidodepaulacolaresnetomdphd combinedtreatmentwithleuprolideacetateandburosumabinxlinkedhypophosphatemiaandprecociouspubertyatherapeuticresponse |