Abstract

Dramatic effect of a non-17 A alkyl testosterone derivative anabolic agent on growth in a child with achondroplasia in the short term

Author(s): Aamir Jalal Al-Mosawi

Background & aim: Achondroplasia is one of the most commonly known types of skeletal dysplasia, leading to short stature and severe rhizomelic dwarfism with extreme, disproportionate, short stature. Hormonal therapy with a growth hormone was associated with a significant effect on height gain in patients with achondroplasia. Currently, growth hormone is available on a limited basis for patients with growth hormone deficiency. The aim of this paper is to report the effects of a limited number of doses of nandrolone decanoate in a child with achondroplasia and very slow growth in the short term. Materials & methods: A 4-year old girl with achondroplasia was referred owing to her parents concern and anxiety regarding her very slow growth. Growth hormone therapy was not available for the child. On referral, her weight was 13 kg and her height was 76.7 cm. Her height was 76.6 cm 6 months before, and baseline growth velocity during the previous 6 months was considered zero. She received nandolone 25 mg by intramuscular injection at days 1, 10 and 40. Results: The novel use of nandrolone in this child with achondroplasia resulted in a dramatic acceleration in growth without the occurrence of unwanted effects or advancement of bone age. At 2 months after the first nandrolone injection, her height was 80.5 cm. Growth velocity during the 2 months of nandrolone use increased from 0 to 1.9 cm/month. Body proportion (sitting height/total height) did not show any significant change. In this geographical location, and due to highly unusual social factors, we are unable to carry out long-term follow-up. Conclusion: The use of nandrolone was associated with a beneficial effect on growth without any obvious adverse effects. However, these results must be confirmed in additional trials in the future.