Central Precocious Puberty as a Complication of Therapy with Adrenocorticotropin (ACTH) and an Aromatase Inhibitor for Refractory Nephrotic Syndrome

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...

Full description

Bibliographic Details
Main Authors: Sungeeta Agrawal, Robert Gensure, Lawrence Milner, Julie Nicoletta, Abdollah Sadeghi-Nejad
Format: Article
Language:English
Published: Hindawi Limited 2019-01-01
Series:Case Reports in Pediatrics
Online Access:http://dx.doi.org/10.1155/2019/1624274
id doaj-5a2b14a074004afa9b193d3ab48311b9
record_format Article
spelling doaj-5a2b14a074004afa9b193d3ab48311b92020-11-25T01:37:18ZengHindawi LimitedCase 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
collection DOAJ
language English
format Article
sources DOAJ
author Sungeeta Agrawal
Robert Gensure
Lawrence Milner
Julie Nicoletta
Abdollah Sadeghi-Nejad
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
author_facet Sungeeta Agrawal
Robert Gensure
Lawrence Milner
Julie Nicoletta
Abdollah Sadeghi-Nejad
author_sort Sungeeta Agrawal
title 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_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_sort central precocious puberty as a complication of therapy with adrenocorticotropin (acth) and an aromatase inhibitor for refractory nephrotic syndrome
publisher Hindawi Limited
series Case Reports in Pediatrics
issn 2090-6803
2090-6811
publishDate 2019-01-01
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.
url http://dx.doi.org/10.1155/2019/1624274
work_keys_str_mv AT sungeetaagrawal centralprecociouspubertyasacomplicationoftherapywithadrenocorticotropinacthandanaromataseinhibitorforrefractorynephroticsyndrome
AT robertgensure centralprecociouspubertyasacomplicationoftherapywithadrenocorticotropinacthandanaromataseinhibitorforrefractorynephroticsyndrome
AT lawrencemilner centralprecociouspubertyasacomplicationoftherapywithadrenocorticotropinacthandanaromataseinhibitorforrefractorynephroticsyndrome
AT julienicoletta centralprecociouspubertyasacomplicationoftherapywithadrenocorticotropinacthandanaromataseinhibitorforrefractorynephroticsyndrome
AT abdollahsadeghinejad centralprecociouspubertyasacomplicationoftherapywithadrenocorticotropinacthandanaromataseinhibitorforrefractorynephroticsyndrome
_version_ 1725058498510716928

Similar Items