Introduction: Estrogen-like endocrine disrupting chemicals (EEDC) are exogenous chemicals that alter endocrine system functions by interfering with estrogens. Several of these substances have been studied but many are still to be discovered. Griseofulvin is a mycotoxic product of Penicillium spp., used for the treatment of dermatophytoses. Case Report: A 4,8 years old girl came to our Clinic for the development of a premature thelarche in the previous two weeks. As she was adopted her perinatal history was unknown, her height was M SDS and her weight -1/M SDS, and Tanner’s stages of B2, P1, A0. The bone age was 5 years and 9 months according to the Greulich and Pyle Atlas. Laboratory findings showed normal thyroid function, HPRL (8 mcg/L), and betaHCG marker (0,10 mcg/L); the Gonadotrophin-releasing hormone analogue (GnRHa) stimulation test revealed high levels of Estradiol, both basal and stimulated (411,0 pmol/L and 275,9 pmol/L) with pre-pubertal values of FSH and LH (FSH from 0.2 to 0.7 U/L and LH from 0.4 to 0.9 U/L). Pelvic ultrasound showed a post-pubertal morphology uterus, an hyperechogenic thick endometrium and some ovaric corpuscolated cysts. Better listening to her history we realised that she had been assuming for the last two weeks an antifungal drug, Griseofulvin to treat Tinea Capitis. We suggested her to stop the drug administration. After a month blood basal Estradiol levels diminished to 73,4 pmol/L and the ultrasound didn't show anymore ovaric cysts even if the uterus still showed postpubertal features. Conclusion: Although we couldn't either measure the quantity of griseofulvin in the blood stream and either its activity on the reproductive system we showed a regression of the clinical, biological and echographic signs of precocious thelarche. We don’t know if griseofulvin can behave as an EEDC but attention is required in its use.

A surprising Case of Premature Thelarche after an anti-fungal therapy

Morandi, Grazia;GAUDINO, Rossella;Piona, Claudia;CAVARZERE, Paolo;MONTI, Elena;ANTONIAZZI, Franco
2012-01-01

Abstract

Introduction: Estrogen-like endocrine disrupting chemicals (EEDC) are exogenous chemicals that alter endocrine system functions by interfering with estrogens. Several of these substances have been studied but many are still to be discovered. Griseofulvin is a mycotoxic product of Penicillium spp., used for the treatment of dermatophytoses. Case Report: A 4,8 years old girl came to our Clinic for the development of a premature thelarche in the previous two weeks. As she was adopted her perinatal history was unknown, her height was M SDS and her weight -1/M SDS, and Tanner’s stages of B2, P1, A0. The bone age was 5 years and 9 months according to the Greulich and Pyle Atlas. Laboratory findings showed normal thyroid function, HPRL (8 mcg/L), and betaHCG marker (0,10 mcg/L); the Gonadotrophin-releasing hormone analogue (GnRHa) stimulation test revealed high levels of Estradiol, both basal and stimulated (411,0 pmol/L and 275,9 pmol/L) with pre-pubertal values of FSH and LH (FSH from 0.2 to 0.7 U/L and LH from 0.4 to 0.9 U/L). Pelvic ultrasound showed a post-pubertal morphology uterus, an hyperechogenic thick endometrium and some ovaric corpuscolated cysts. Better listening to her history we realised that she had been assuming for the last two weeks an antifungal drug, Griseofulvin to treat Tinea Capitis. We suggested her to stop the drug administration. After a month blood basal Estradiol levels diminished to 73,4 pmol/L and the ultrasound didn't show anymore ovaric cysts even if the uterus still showed postpubertal features. Conclusion: Although we couldn't either measure the quantity of griseofulvin in the blood stream and either its activity on the reproductive system we showed a regression of the clinical, biological and echographic signs of precocious thelarche. We don’t know if griseofulvin can behave as an EEDC but attention is required in its use.
premature thelarche; EEDC
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/877397
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