Topical dihydrotestosterone to treat micropenis secondary to partial androgen insensitivity syndrome (PAIS) before, during, and after puberty - a case series
| Autor: | Victoria Stott, Jacqui Milburn, Sonal J. Gosai, Nina K. Henderson, Benjamin J Wheeler, David Becker, Yih Harng Chong, Lisa M. Wain |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.drug_class Endocrinology Diabetes and Metabolism Administration Topical 030209 endocrinology & metabolism 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology Internal medicine Medicine Humans Partial androgen insensitivity syndrome Child Testosterone 030219 obstetrics & reproductive medicine business.industry Puberty Androstanolone Dihydrotestosterone Micropenis Androgen-Insensitivity Syndrome Androgen medicine.disease Pedigree Androgen receptor Pediatrics Perinatology and Child Health Androgen insensitivity syndrome Genital Diseases Male business medicine.drug Penis |
| Zdroj: | Journal of pediatric endocrinologymetabolism : JPEM. 29(2) |
| ISSN: | 2191-0251 |
| Popis: | X-linked partial androgen insensitivity syndrome (PAIS) causes under-virilization at all stages of development. In two thirds of males, this results in micropenis. Dihydrotestosterone (DHT) is a potent androgen that is critical for male genital development, which when applied topically, has been shown to increase penile length with micropenis of varying etiologies. We present the first case series using topical DHT gel to treat micropenis in 46,XY males with PAIS, before, during, and after puberty.Three related 46,XY males with confirmed p.L712F androgen receptor mutations exhibited varying degrees of micropenis post-surgical correction. They were of pre-pubertal, peri-pubertal and adult ages, respectively. Following baseline clinical and laboratory assessments all completed a 4-month course of daily DHT gel 2.5% (androstanolone) topically to penis (0.3 mg/kg body weight), with monitoring for adverse effects. Primary outcome was change in stretched penile length (SPL) following treatment.Mixed results were obtained following topical DHT therapy. In the pre- and peri- pubertal patients, SPL changed from 2.5 cm to 3.5 cm (+40%), and 3.5 cm to 5.7 cm (+63%), respectively. In the adult patient with 1 year of prior high-dose weekly testosterone therapy, no additional change in SPL was seen. No adverse effects of topical DHT were reported or observed throughout the 4 months of treatment.Topical DHT treatment appears to be a safe and well-tolerated method of virilising micropenis both prior to and during puberty in children with PAIS. Questions remain about long-term outcomes into adulthood, and efficacy in adults with prior lengthy exposure to high-dose testosterone. |
| Databáze: | OpenAIRE |
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