Growth Hormone Deficiency Letrozole Significantly Improves Growth Potential in a Pubertal Boy With

ABSTRACT. Clinical experience with using an aro-matase inhibitor to suppress estrogen production duringpuberty for improvement of growth potential in adoles-cents with short stature is limited. This report documentstreatment of such a patient with a combination of growthhormone and letrozole, a third-generation aromatase in-hibitor. Our case demonstrates a favorable outcome on ashort-term basis. Pediatrics 2005;115:e245–e248. URL:www.pediatrics.org/cgi/doi/10.1542/peds.2004-1536; bonemineral density, growth hormone, hormonal control, shortstature, aromatase inhibitor. ABBREVIATIONS. AI, aromatase inhibitor; BMD, bone mineraldensity; GH, growth hormone; PTH, parathyroid hormone; IGF,insulin-like growth factor. E strogen plays a critical role for the pubertalgrowth spurt, skeletal maturation, and accrualand maintenance of bone mass in females aswell as males. 1–4 It is now evident that gene muta-tions of aromatase or estrogen receptor that result inimpairment of estrogen production or action havesimilar phenotypes, including abnormally tall stat-ure with eunuchoid proportions, a lack of pubertalgrowth spurt, unfused epiphyses, and osteopenia.Aromatase, encoded by the