What helps boys with early puberty when standard treatment doesn't work?

Original Title

SUN-187 Gonadotropin-Releasing Hormone Agonist Resistant Central Precocious Puberty in Males with Hypothalamic Hamartoma: A Two-Center Case Series

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Summary

Two boys who started puberty very early because of a brain condition didn’t respond fully to normal treatment. One got three medicines instead of two, and his growth and bone age got better over 10 years. The other, on two medicines, kept growing too fast.

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Surprising Findings

Testosterone was not fully suppressed despite long-term GnRHa and aromatase inhibitor therapy.

GnRHa is considered highly effective at halting puberty, so resistance—especially with continued high testosterone—is unexpected and clinically challenging.

Practical Takeaways

For boys with hypothalamic hamartoma and incomplete response to standard CPP treatment, adding an antiandrogen like bicalutamide may improve growth and bone maturation control.

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