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      Central Precocious Puberty: A Single Blood Sample after Gonadotropin-Releasing Hormone Agonist Administration in Monitoring Treatment

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          Abstract

          This study was designed to evaluate whether a single blood sample drawn after the home injection of a long-acting gonadotropin-releasing hormone (GnRH) agonist (GnRHa) in patients treated for central precocious puberty (CPP) could be a more simple and inexpensive test with respect to the conventional GnRH stimulating test in assessing adequate suppression of the pituitary-gonadal axis. The response to the first therapeutic injection of the GnRHa triptorelin was studied in 14 newly diagnosed untreated females with CPP. The results were compared with the response that the same patients had to the conventional GnRH stimulation test performed at the time of diagnosis. A significant increase in LH, FSH and E<sub>2</sub> levels was observed 12 h after the triptorelin intramuscular injection; serum peak values of LH (70.3 ± 58.5 IU/l), FSH (44.2 ± 21.7 IU/l) and E<sub>2</sub> (489.7 ± 263.9 pmol/l) were significantly greater than those obtained with the conventional GnRH test (LH 31.4 ± 21.7, p = 0.002; FSH 19.8 ± 10.7, p = 0.001; E<sub>2</sub> 83.3 ± 25, p < 0.001). In particular, the E<sub>2</sub> response, 12 h after triptorelin injection, was clearly consistent with gonadal activation compared to the modest E<sub>2</sub> increase in response to the GnRH test. Thereafter 22 girls who were already being treated with triptorelin for CPP were evaluated to see whether a single blood sample drawn 12 h after the therapeutic home injection of GnRHa could be informative in assessing adequate suppression of the pituitary-gonadal axis. This response was also compared to the conventional GnRH stimulation test performed 2 days before the therapeutic triptorelin injection. In 7 girls with evidence of pubertal progression, the E<sub>2</sub> response following the GnRHa injection (136.3 ± 44.4 pmol/l) was significantly higher with respect to the response after the GnRH stimulation test (73.0 ± 0.0; p < 0.02) indicating an inadequate suppression of the pituitary-gonadal axis. The present data suggest that a single blood sample drawn 12 h after the therapeutic home administration of triptorelin provides a simple, comfortable and inexpensive means of monitoring pituitary as well as gonadal function in girls treated for CPP.

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          Most cited references 1

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          Use of leuprolide acetate response patterns in the early diagnosis of pubertal disorders: comparison with the gonadotropin-releasing hormone test

           L Ibáñez (1994)
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            Author and article information

            Journal
            HRE
            Horm Res Paediatr
            10.1159/issn.1663-2818
            Hormone Research in Paediatrics
            S. Karger AG
            1663-2818
            1663-2826
            1998
            October 1998
            04 December 1998
            : 50
            : 4
            : 205-211
            Affiliations
            Departments of a Pediatrics and b Clinical Pathology, University ‘Federico II’, Naples, and c Department of Pediatrics (DPMSC), University of Udine, Italy
            Article
            23275 Horm Res 1998;50:205–211
            10.1159/000023275
            9838241
            © 1998 S. Karger AG, Basel

            Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

            Page count
            Figures: 2, Tables: 3, References: 21, Pages: 7
            Categories
            Original Paper

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