cyproterone and Hypogonadism

Two male patients with hypogonadism and four female patients who received an anti-androgen as contraceptive (cyproteronacetate) and who had recurrent angioedema are described. In one male patient, augmentation of the plasma androgen level resulted in disappearance of symptoms. In the four female patients, recurrent angioedema and urticaria developed after initiation of the anti-androgen treatment. Cessation of cyproteronacetate and a change to another contraceptive resulted in complete resolution of the previously frequent angioedematous attacks. The women are still symptom free after more than 60 patient's months. These cases suggest that an androgen deficit due to either hypogonadism or to anti-androgen treatment may be another cause of angioedema. One of the two male patients was untreated and presented with 40% normal value of C1-INH. Androgen therapy normalized C1-INH concentration in this male patient. Functional C1-INH in the same patient, studied before and after the beginning of androgen therapy, clearly increased when assessed by inhibition of amidolytic activity of C1-esterase. The other male patient with hypogonadism had already been under androgen treatment for 4 years and had C1-INH levels in the normal range. In the female patients, complement profiles were normal before and after cessation of anti-androgen contraception; however, the C1-INH plasma levels were higher after cessation of anti-androgen anticonception. These results indicate an effect of androgen deficit on the level of C1-INH in circulating plasma but do not prove a role of C1-INH in angioedema associated with diminished androgen plasma levels.

Topics: Adult; Androgen Antagonists; Angioedema; Complement C1 Inactivator Proteins; Cyproterone; Cyproterone Acetate; Female; Humans; Hypogonadism; Male

In order to evaluate the secretory patterns of luteinizing and follicle-stimulating hormones in various forms of abnormal sexual development, plasma levels of these hormones were measured every 20-30 minutes during sleep in 9 patients with true precocious puberty and 2 patients with primary hypogonadism. Seven patients with idiopathic precocious puberty and 2 patients with organic CNS lesion-related precocious puberty exhibited fluctuating plasma concentrations of these hormones that resembled findings in normal pubertal subjects who had significantly increased concentrations of plasma luteinizing hormone during sleep. Two patients with primary hypogonadism also showed episodic fluctuation of both hormones and augmented luteinizing hormone concentrations during sleep. These results suggest that the pubertal sleep-related gonadotropin secretion is dependent on the sleep-entrained CNS mechanism, and that the central nervous system plays an important role in sexual maturation.

Topics: Adolescent; Central Nervous System; Child; Child, Preschool; Cyproterone; Cyproterone Acetate; Female; Follicle Stimulating Hormone; Gonadotropin-Releasing Hormone; Humans; Hypogonadism; Luteinizing Hormone; Puberty; Puberty, Precocious; Sleep

The pubertal growth spurt is based on synergistic effects of hGH and androgenic steroids. It fails to appear in androgen deficiency as well as in complete absence of hGH. Apart from the synergism of biological functions there are interactions with regard to the secretion of hGH and androgens. Investigating the nocturnal hGH-secretion in puberty stage 3 we found twice as high secretion rates as in stage 1. Children with anorchia or constitutional delay of growth and adolescence during treatment with testosterone secreted more than threefold amounts of hGH as before. In two cyproterone acetate-treated adolescents, and in four 12-19 years old patients with hypogonadism, the nocturnal secretion rates of hGH as well as the maximal hGH-peaks attained were lower than in normal prepubertal children. The conclusion is drawn that the androgen-secretion during adolescence is not only prerequisite to the hGH-increment necessary for the pubertal growth spurt but also to the preservation of basal hGH-secretion.

Topics: Adolescent; Androgens; Child; Cyproterone; Female; Growth; Growth Hormone; Humans; Hypogonadism; Male; Puberty