Please use this identifier to cite or link to this item: http://hdl.handle.net/10553/120806
Title: Recovery of hypothalamic-pituitary-gonadal function with low dose testosterone treatment in a male with congenital hypogonadotropic hypogonadism
Authors: Braca, Fernando
Betancort, Juan C.
Pérez-Martín, Núria
Cabrera Argany, Álvaro
Boronat Cortés, Mauro 
UNESCO Clasification: 32 Ciencias médicas
3205 Medicina interna
230215 Hormonas
Keywords: Congenital hypogonadotropic hypogonadism
Constitutional delay of growth and puberty
Reversal
Testosterone
Issue Date: 2022
Journal: Andrologia 
Abstract: Congenital hypogonadotropic hypogonadism (CHH) is a rare disease caused by deficiency or action of gonadotropin-releasing hormone. While generally considered a long-life condition, CHH can be reversible in about 5%–20% of cases, but mechanisms of reversibility are unknown. We report the case of a male with CHH who began treatment with low dose (20 mg/day) transdermal testosterone to induce pubertal development at age 17. Following the start of treatment, he experienced testicular growth and his serum testosterone concentrations increased beyond the expectations in relation to the dose. Treatment was withdrawn, but this led to the reappearance of symptoms of hypogonadism and a drop in testosterone levels. Testosterone was again prescribed at the same dose and, for the subsequent years, he completed full puberty, including attainment of 20 cc testicular volume, mature secondary sexual characteristics, normal levels of testosterone and only partially arrested germinal function, as demonstrated by inhibin B levels and spermogram. Testosterone treatment was withdrawn three more times, but hypogonadism resumed on each occasion. This case suggests that low-dose testosterone treatment can induce reversal of CHH through the activation, albeit non-permanent, of the hypothalamic–pituitary–gonadal axis, indicating that testosterone administration might be a reliable therapeutic option for reverting GnRH deficiency.
URI: http://hdl.handle.net/10553/120806
ISSN: 0303-4569
DOI: 10.1111/and.14628
Source: Andrologia [ISSN 0303-4569], v. 54 (11), e14628, (Diciembre 2022)
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