author_facet Kirk, Jeremy M W
Wickramasuriya, Nalin
Shaw, Nicholas J
Kirk, Jeremy M W
Wickramasuriya, Nalin
Shaw, Nicholas J
author Kirk, Jeremy M W
Wickramasuriya, Nalin
Shaw, Nicholas J
spellingShingle Kirk, Jeremy M W
Wickramasuriya, Nalin
Shaw, Nicholas J
Endocrinology, Diabetes & Metabolism Case Reports
Estradiol: micrograms or milligrams
Endocrinology, Diabetes and Metabolism
Internal Medicine
author_sort kirk, jeremy m w
spelling Kirk, Jeremy M W Wickramasuriya, Nalin Shaw, Nicholas J 2052-0573 Bioscientifica Endocrinology, Diabetes and Metabolism Internal Medicine http://dx.doi.org/10.1530/edm-15-0096 <jats:title>Summary</jats:title> <jats:p>Estrogen is used to induce puberty in peripubertal girls with hypogonadism. Although both synthetic and natural forms are available, along with different routes of administration, in the UK oral ethinyl estradiol and the low-dose oral contraceptive pill are commonly used as hormone replacement therapy for practical reasons. We present five peripubertal girls (aged 12.5–14.9 years) with hypogonadism (two with primary hypogonadism due to Turner syndrome and three with central (secondary) hypogonadism as part of multiple pituitary hormone deficiency) who for a variety of reasons have received milligram doses of estradiol (E<jats:sub>2</jats:sub>) in error for between 6 weeks and 6 months, instead of the expected microgram doses of ethinyl estradiol. Although there are no direct comparisons in peripubertal girls between synthetic and natural estrogens, all girls had vaginal bleeding whilst receiving the milligram doses and have ended up with reduced final heights, below the 9th centile in 1 and below the 2nd centile in 4. Whilst reduction in final height may be part of the underlying condition (especially in Turner syndrome) the two girls with height predictions performed prior to receiving the estrogen overdose have not achieved their predicted height. Estrogen is one of the few drugs which is available in both milligram and microgram formulations. Clinicians need to be alert to the possibility of patients receiving the wrong formulation and dosage in error.</jats:p> <jats:sec> <jats:title>Learning points</jats:title> <jats:p> <jats:list list-type="bullet"> <jats:list-item> <jats:p>Girls with primary and secondary gonadal failure require assistance with pubertal induction.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Although several different formulations and route of administration are available, for practical reasons, the majority of girls in the UK receive oral ethinyl estradiol.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Estrogen preparations are available in both milligram and microgram formulations, with potential for receiving the wrong dose.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Girls receiving milligram rather than microgram preparations all had vaginal bleeding and a short final height.</jats:p> </jats:list-item> </jats:list> </jats:p> </jats:sec> Estradiol: micrograms or milligrams Endocrinology, Diabetes & Metabolism Case Reports
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title Estradiol: micrograms or milligrams
title_unstemmed Estradiol: micrograms or milligrams
title_full Estradiol: micrograms or milligrams
title_fullStr Estradiol: micrograms or milligrams
title_full_unstemmed Estradiol: micrograms or milligrams
title_short Estradiol: micrograms or milligrams
title_sort estradiol: micrograms or milligrams
topic Endocrinology, Diabetes and Metabolism
Internal Medicine
url http://dx.doi.org/10.1530/edm-15-0096
publishDate 2016
physical
description <jats:title>Summary</jats:title> <jats:p>Estrogen is used to induce puberty in peripubertal girls with hypogonadism. Although both synthetic and natural forms are available, along with different routes of administration, in the UK oral ethinyl estradiol and the low-dose oral contraceptive pill are commonly used as hormone replacement therapy for practical reasons. We present five peripubertal girls (aged 12.5–14.9 years) with hypogonadism (two with primary hypogonadism due to Turner syndrome and three with central (secondary) hypogonadism as part of multiple pituitary hormone deficiency) who for a variety of reasons have received milligram doses of estradiol (E<jats:sub>2</jats:sub>) in error for between 6 weeks and 6 months, instead of the expected microgram doses of ethinyl estradiol. Although there are no direct comparisons in peripubertal girls between synthetic and natural estrogens, all girls had vaginal bleeding whilst receiving the milligram doses and have ended up with reduced final heights, below the 9th centile in 1 and below the 2nd centile in 4. Whilst reduction in final height may be part of the underlying condition (especially in Turner syndrome) the two girls with height predictions performed prior to receiving the estrogen overdose have not achieved their predicted height. Estrogen is one of the few drugs which is available in both milligram and microgram formulations. Clinicians need to be alert to the possibility of patients receiving the wrong formulation and dosage in error.</jats:p> <jats:sec> <jats:title>Learning points</jats:title> <jats:p> <jats:list list-type="bullet"> <jats:list-item> <jats:p>Girls with primary and secondary gonadal failure require assistance with pubertal induction.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Although several different formulations and route of administration are available, for practical reasons, the majority of girls in the UK receive oral ethinyl estradiol.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Estrogen preparations are available in both milligram and microgram formulations, with potential for receiving the wrong dose.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Girls receiving milligram rather than microgram preparations all had vaginal bleeding and a short final height.</jats:p> </jats:list-item> </jats:list> </jats:p> </jats:sec>
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description <jats:title>Summary</jats:title> <jats:p>Estrogen is used to induce puberty in peripubertal girls with hypogonadism. Although both synthetic and natural forms are available, along with different routes of administration, in the UK oral ethinyl estradiol and the low-dose oral contraceptive pill are commonly used as hormone replacement therapy for practical reasons. We present five peripubertal girls (aged 12.5–14.9 years) with hypogonadism (two with primary hypogonadism due to Turner syndrome and three with central (secondary) hypogonadism as part of multiple pituitary hormone deficiency) who for a variety of reasons have received milligram doses of estradiol (E<jats:sub>2</jats:sub>) in error for between 6 weeks and 6 months, instead of the expected microgram doses of ethinyl estradiol. Although there are no direct comparisons in peripubertal girls between synthetic and natural estrogens, all girls had vaginal bleeding whilst receiving the milligram doses and have ended up with reduced final heights, below the 9th centile in 1 and below the 2nd centile in 4. Whilst reduction in final height may be part of the underlying condition (especially in Turner syndrome) the two girls with height predictions performed prior to receiving the estrogen overdose have not achieved their predicted height. Estrogen is one of the few drugs which is available in both milligram and microgram formulations. Clinicians need to be alert to the possibility of patients receiving the wrong formulation and dosage in error.</jats:p> <jats:sec> <jats:title>Learning points</jats:title> <jats:p> <jats:list list-type="bullet"> <jats:list-item> <jats:p>Girls with primary and secondary gonadal failure require assistance with pubertal induction.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Although several different formulations and route of administration are available, for practical reasons, the majority of girls in the UK receive oral ethinyl estradiol.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Estrogen preparations are available in both milligram and microgram formulations, with potential for receiving the wrong dose.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Girls receiving milligram rather than microgram preparations all had vaginal bleeding and a short final height.</jats:p> </jats:list-item> </jats:list> </jats:p> </jats:sec>
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spelling Kirk, Jeremy M W Wickramasuriya, Nalin Shaw, Nicholas J 2052-0573 Bioscientifica Endocrinology, Diabetes and Metabolism Internal Medicine http://dx.doi.org/10.1530/edm-15-0096 <jats:title>Summary</jats:title> <jats:p>Estrogen is used to induce puberty in peripubertal girls with hypogonadism. Although both synthetic and natural forms are available, along with different routes of administration, in the UK oral ethinyl estradiol and the low-dose oral contraceptive pill are commonly used as hormone replacement therapy for practical reasons. We present five peripubertal girls (aged 12.5–14.9 years) with hypogonadism (two with primary hypogonadism due to Turner syndrome and three with central (secondary) hypogonadism as part of multiple pituitary hormone deficiency) who for a variety of reasons have received milligram doses of estradiol (E<jats:sub>2</jats:sub>) in error for between 6 weeks and 6 months, instead of the expected microgram doses of ethinyl estradiol. Although there are no direct comparisons in peripubertal girls between synthetic and natural estrogens, all girls had vaginal bleeding whilst receiving the milligram doses and have ended up with reduced final heights, below the 9th centile in 1 and below the 2nd centile in 4. Whilst reduction in final height may be part of the underlying condition (especially in Turner syndrome) the two girls with height predictions performed prior to receiving the estrogen overdose have not achieved their predicted height. Estrogen is one of the few drugs which is available in both milligram and microgram formulations. Clinicians need to be alert to the possibility of patients receiving the wrong formulation and dosage in error.</jats:p> <jats:sec> <jats:title>Learning points</jats:title> <jats:p> <jats:list list-type="bullet"> <jats:list-item> <jats:p>Girls with primary and secondary gonadal failure require assistance with pubertal induction.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Although several different formulations and route of administration are available, for practical reasons, the majority of girls in the UK receive oral ethinyl estradiol.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Estrogen preparations are available in both milligram and microgram formulations, with potential for receiving the wrong dose.</jats:p> </jats:list-item> <jats:list-item> <jats:p>Girls receiving milligram rather than microgram preparations all had vaginal bleeding and a short final height.</jats:p> </jats:list-item> </jats:list> </jats:p> </jats:sec> Estradiol: micrograms or milligrams Endocrinology, Diabetes & Metabolism Case Reports
spellingShingle Kirk, Jeremy M W, Wickramasuriya, Nalin, Shaw, Nicholas J, Endocrinology, Diabetes & Metabolism Case Reports, Estradiol: micrograms or milligrams, Endocrinology, Diabetes and Metabolism, Internal Medicine
title Estradiol: micrograms or milligrams
title_full Estradiol: micrograms or milligrams
title_fullStr Estradiol: micrograms or milligrams
title_full_unstemmed Estradiol: micrograms or milligrams
title_short Estradiol: micrograms or milligrams
title_sort estradiol: micrograms or milligrams
title_unstemmed Estradiol: micrograms or milligrams
topic Endocrinology, Diabetes and Metabolism, Internal Medicine
url http://dx.doi.org/10.1530/edm-15-0096