Efeitos do tratamento com análogo do hormônio liberador de gonadotrofinas sobre a estatura final em meninos com puberdade precoce central em um Centro de Referência, no estado da Bahia (1998-2014)

Abstract

Effects on the final height results after gonadotropin releasing hormone agonist treatment in boys with central precocious puberty in a reference center, in the state of bahia (1998-2014) Theoretical foundation: Precocious puberty is the puberal development before 9 years of age, in boys, and, in most cases, is gonadotropin-dependent (CPP - Central Precocious Puberty). The standard drug treatment is the gonadotropin-releasing hormone agonist, that suppresses the hypothalamic-pituitary-gonadal axis. Objective: describe the effects on the final height of the gonadotropin-releasing hormone agonist treatment and evaluate their psychological impacts in the patients. Methods: ambispective longitudinal study. First stage (retrospective): analysis of medical records of 66 male patients diagnosed with CPP, treated with GnRHa in a reference center (CEDEBA); Second stage (prospective): data of 14 patients who completed the treatment and answered the evaluation questionnaire. Results: The final height was 171 ± 5,1 cm. Since the beginning of the treatment until reaching its final height the growth was 28,3 ± 13,3 cm. The ratio between the final height and the target height was 0,99 ± 0,03. The height gain was of 0,5 ± 6 cm. After the end of the treatment the patients still grew 11,5 ± 2,7 cm until the growth stop. A lower age of treatment initiation and longer duration were predictors of higher real growth rate (p<0,05). 92,8% of the patients were afraid of keep the short stature in adulthood before the start of therapy. 100% of patients do not regret treatment, 92,8% would do it again if was necessary and 78,6% are satisfied with their final height. Reduction in the number of individuals who reported to be aggressive, had relationship problems, difficulty concentrating and/or mood changes after end of treatment. Conclusions: The treatment performed at CEDEBA plays all its role: it has a positive and significant impact on the final height, preventing stature loss, and also being positive from the psychological point of view, important parameters to initiate the therapy and consequently to evaluate its efficiency.