Treatment of excessive height in girls. A long-term study

Estrogen treatment of tall girls: dose dependency of effects on subsequent growth and IGF-I levels in blood

Three groups of girls with mean final height predictions of 185.3 cm were treated in 3-week cycles with 0.25, 0.5, or 1.0 mg of ethinylestradiol. The three groups were comparable with regard to chronological age, bone age, height prediction, and duration of treatment. Reduction in final height of 5.5-5.9 cm/group in comparison with the initial prediction was observed in all treated groups. This reduction appeared independent of estrogen dose. Subsequent height increases were limited to about 50% of the predicted gain in all cases. In a comparable group of untreated tall girls the prediction method overestimated the final height by 1.2 cm. In the groups receiving 1.0 and 0.5 mg EtE2 a significant reduction in IGF-I levels was achieved within three to six months after the start of estrogen therapy.

Estrogen treatment in tall girls

36 tall girls aged 10.3 to 15.5 years were treated with ethinylestradiol (0.5 mg/day) and norethisterone (15 mg/day). To date treatment for seventeen girls has been completed. Before treatment their bone age ranged from 11.0 to 13.5 years and mean height prediction was 185.19 cm (181.40-193.00 cm). After about two years of treatment their final height averaged 178.96 cm (171.60-183.50 cm). Predicted height was reduced by an average of 6.23 cm. The reduction in final height was significantly greater when therapy was started before a bone age of 12 years. Thirteen girls, re-examined after discontinuation of therapy, all had regular menstrual bleeding within six months. There were no serious or irreversible side effects during the period of observation.

Tall girls: a survey of 15 years of management and treatment

In the past 15 years 450 girls have been seen because of concern about tall stature: 168 of them have been treated with stilbestrol to control the growth rate. Of the latter group 87 have been followed after treatment for a sufficiently long time to be sure growth had ceased and to provide the data for this report. At the onset of treatment the following data (mean values) were recorded: chronologic age, 13.0 years; skeletal age, 13.2 years; height, 172.9 cm; estimated mature height 180.2 cm; and growth potential, 7.3 cm. At the end of treatment data of interest (mean values) were: reduction in final height, 3.5 cm; duration of therapy, 2.1 years; amount of stilbestrol given, 2.3 gm; age of last visit, 17.6 years. Side effects were minimal, though two girls developed parovarian cysts that required surgery during treatment. Not included in the series of 87, one additional girl was seen with a serous cystadenoma of the ovary, and one girl developed superficial venous thrombosis of the calf. Long-term follow-up has revealed no late complications. It is concluded that estrogen can reduce significantly the growth rate of almost all tall girls, but treatment must be carried out under very careful supervision, bearing in mind possible side effects.

Investigation of carbohydrate metabolism and somatomedin in osteosarcoma patients

Altered carbohydrate metabolism associated with fibrosarcomas and chondrosarcomas has been well-documented in past literature. This report describes abnormal carbohydrate metabolism in 2 osteosarcoma patients, and abnormalities in growth hormone and somatomedin serum levels. Experimental evidence is presented showing in vitro suppression of osteosarcoma tumor cell proliferation by 17 beta Estradiol. Estrogen inhibition of linear bone growth, cartilage proliferation, and somatomedin is discussed with reference to possible estrogen therapy in osteosarcoma.