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Home > Case report. Development of central precocious puberty following cannabinoid use for paediatric epilepsy: causal or coincidence?

Krishnan, Aditya and Chizo Agwu, Juliana and Kallappa, Chetana and Pandey, Ragesh (2021) Case report. Development of central precocious puberty following cannabinoid use for paediatric epilepsy: causal or coincidence? BMJ Case Reports, 14, e239678. /10.1136/bcr-2020-239678.

External website: https://casereports.bmj.com/content/14/4/e239678


Research suggests a role for cannabidiol oil in managing certain forms of paediatric onset epilepsy. However, studies on the impact of cannabis on the hypothalamo-pituitary-gonadal (HPG) axis have conflicting results. Delta-9-tetrahydrocannabinol (Δ9-THC) acutely inhibits gonadotropin-releasing hormone in the hypothalamus, reducing testosterone levels by 65% in rhesus monkeys. Additionally, there have been reports of pubertal arrest and delayed puberty in male cannabis users. In contrast, other studies have reported higher testosterone levels following long-term cannabis use.

A 2-year-old boy presented with testicular enlargement, increased penile length and growth of coarse pubic hair developing over 6 months. His mother procured cannabidiol oil online, which he started taking 7 months earlier for severe epilepsy refractory to medical management. Subsequent investigations confirmed central precocious puberty. While it is unclear whether the precocious puberty is a direct consequence of HPG axis activation by Δ9-THC, this case demonstrates a temporal association between cannabis use and development of precocious puberty.

Item Type
Article
Publication Type
International, Open Access, Article
Drug Type
Cannabis, Prescription/Over the counter
Intervention Type
Drug therapy
Date
April 2021
Identification #
/10.1136/bcr-2020-239678
Page Range
e239678
Publisher
BMJ Group
Volume
14
EndNote

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