Somatostatin Analog and Estrogen Treatment in a Tall Girl

A girl aged 10 years and 7months who was 168.9 cm tall was diagnosed as having familial tall stature and was treated with a combination of octreotide acetate (50 μg. sc injection three times daily) and Kaufmann therapy (Premarin 2.5 mg/day for 26 days a month with Provera 10 mg for the last 7 days with Premarin, cyclically) for 25 months to reduce final height. Serum insulin-like growth factor I (IGF-I) and the urinary growth hormone (GH) level decreased and serum gonadotropins were completely suppressed during the treatment. After discontinuation of the treatment, serum IGF-I, urinary GH, and gonadotropins returned to the pubertal level. Her height velocity decreased and bone age advanced from 11.4 years to 14 years during the 25-month treatment. When the treatment was discontinued at the chronological age of 12 years and 11 months, her bone age was 14 years and her height was 176.4 cm. She has almost stopped growing at 13 years and 11 months, and has reached a final height of 177.6 cm.Since the patient grew only 7.9 cm during puberty, it can be concluded that the combination treatment was very effective in reduction of final height.