%0 Journal Article
%T Prenatal Virilization Associated with Paternal Testosterone Gel Therapy
%A Anisha Patel
%A Scott A Rivkees
%J International Journal of Pediatric Endocrinology
%D 2010
%I BioMed Central
%R 10.1155/2010/867471
%X Transdermal testosterone gels are used in the treatment of hypoandrogenism of males [1]. Virilization due to exposure to testosterone gels has been reported in children ranging from 9 months to 5 years of age [2¨C6]. In May 2009, the US Food and Drug Administration (FDA) issued a warning for testosterone gel products (AndroGel 1% and Testim 1%), alerting prescribers about secondary exposure to these products [7]. Based on interrogation of medical literature databases, at present we are unaware of prenatal virilization associated with unintentional testosterone gel exposure. We now report prenatal virilization of a female infant due to secondary maternal exposure to the father's testosterone gel. We also describe postnatal virilization of the child's twin sister.Dizygotic twin girls were born after a 30-week gestation. Pregnancy was complicated by premature labor at 26 weeks of gestation requiring 12£¿mg betamethasone treatment for two days. Medications taken during pregnancy were Wellbutrin, Pepcid, Procardia, and Indocin. The birth weight for Twin A was 1700£¿gm and Twin B was 1660£¿gm.Twin A required intubation and mechanical ventilation for 4 days followed by continuous positive airway pressure (CPAP) until day of life 8. Twin B required CPAP for 8 days. Both infants had apnea of prematurity and mild hyperbilirubinemia. The infants were discharged to home at 37 weeks post conception age.At birth, Twin A was found to have clitoromegaly () [8] and was Prader Stage 2. Twin B did not have clitoromegaly (). The urethral openings of the twins were at the base of the phallus.At 96£¿hours of age, the total testosterone of the virilized twin was 9.8£¿ng/dL (0.4£¿nM), androstenedione was 71£¿ng/dL (2£¿nM), and the 17-hydroxyprogesterone was 82£¿ng/dL (2.4£¿nM) (Table 1; hormonal determinations performed at Esoterix Laboratory Services, Casablanca Hills, CA).Transabdominal ultrasound showed normal Mullerian structures with no evidence of persistent Wolffian structures. The uterus meas
%U http://www.ijpeonline.com/content/2010/1/867471