Cirrhosis in a child with hypothalamic syndrome and central precocious puberty treated with cyproterone acetate

• Published in: European journal of pediatrics 1999-05, Vol.158 (5), p.367-370
• Main Authors: GARTY, B. Z, DINARI, G, GELLVAN, A, KAULI, R
• Format: Article
• Language: English
• Subjects: Adolescent; Biological and medical sciences; Chemical and Drug Induced Liver Injury - complications; Chemical and Drug Induced Liver Injury - diagnosis; Chemical and Drug Induced Liver Injury - etiology; Child; Cyproterone Acetate - adverse effects; Cyproterone Acetate - therapeutic use; Drug toxicity and drugs side effects treatment; Fatal Outcome; Humans; Hypothalamic Diseases - complications; Hypothalamic Diseases - diagnosis; Hypothalamic Diseases - drug therapy; Liver Cirrhosis - chemically induced; Liver Cirrhosis - complications; Liver Cirrhosis - diagnosis; Male; Medical sciences; Multiple Organ Failure - etiology; Pharmacology. Drug treatments; Progesterone Congeners - adverse effects; Progesterone Congeners - therapeutic use; Puberty, Precocious - complications; Puberty, Precocious - diagnosis; Puberty, Precocious - drug therapy; Sepsis - etiology; Syndrome; Toxicity: digestive system
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s004310051093

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. Prolonged cyproterone acetate treatment may induce cirrhosis. Monitoring of liver function both during treatment and for several months after discontinuation of therapy is recommended.