Assessment of Basal and Gonadotropin-Releasing Hormone-Stimulated Gonadotropins by Immunochemiluminometric and Immunofluorometric Assays in Normal Children

Resende, Elisabete Aparecida Mantovani Rodrigues de; Lara, Beatriz Hallal Jorge; Reis, Joana; Ferreira, Béatriz; Pereira, Gilberto A.; Borges, Maria F.

doi:10.1210/jc.2006-1569

Cited by 187 publications

(148 citation statements)

References 21 publications

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“…For convenience, some practitioners monitor therapy using unstimulated basal LH levels. Our data demonstrate that this practice should be used cautiously, particularly in the first year of therapy, when basal LH levels are routinely elevated above prepubertal norms [20, 21, 24]. Like peak LH, basal LH showed a downward trend during treatment, with the mean falling to approximately 0.3 IU/L by 24 weeks.…”

Section: Discussionmentioning

confidence: 72%

Leuprolide Acetate 1-Month Depot for Central Precocious Puberty: Hormonal Suppression and Recovery

Neely

Lee

Bloch

et al. 2010

International Journal of Pediatric Endocrinology

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Methods. This prospective US multicenter trial of leuprolide acetate 1-month depot (7.5–15 mg) for central precocious puberty utilized an open-label treatment period, long-term follow-up, and adult callback. Forty-nine females <9 years old with Tanner breast stage ≥2 before 8 years and 6 males <10 years old with Tanner genital stage ≥2 before 9 years with stimulated LH ≥10 IU/L and bone age advance ≥1 year were enrolled. Results. Subjects were treated for 3.9 ± 2.0 years. Mean peak GnRH-stimulated LH and FSH were prepubertal after the first dose and remained suppressed throughout treatment. During treatment, mean estradiol decreased to the limit of detection and mean testosterone decreased but remained above prepubertal norms. During posttreatment follow-up (3.5 ± 2.2 years), all patients achieved a pubertal hormonal response within 1 year and menses were reported in all females ≥12 years old. No impairment of reproductive function was observed at adulthood (mean age: 24.8 years).

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Section: Discussionmentioning

confidence: 72%

Leuprolide Acetate 1-Month Depot for Central Precocious Puberty: Hormonal Suppression and Recovery

Neely

Lee

Bloch

et al. 2010

International Journal of Pediatric Endocrinology

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“…The sensitivity of serum LH at baseline morning for diagnosis of CPP, mainly in girls, varies between 60 and 100%, depending on the cutoff value and laboratory methodology (16 Table 2 (27,28,(30)(31)(32)(33)(34)(35)(36)(37)(38). In girls, serum levels of E2 are not used to diagnose CPP, considering their low sensitivity and large overlap between normal prepubertal and pubertal children (26).…”

Section: Laboratory Diagnosis Hormonal Assessmentmentioning

confidence: 99%

“…GnRHa acts on the anterior pituitary, competing for GnRH receptor with endogenous GnRH, promoting endocytosis and reducing the amount of GnRH receptors ("down-regulation") (46)(47)(48). Initially, GnRHa stimulates the synthesis and secretion of LH and FSH but when it is administered chronically, GnRHa suppresses the production of these hormones, which in turn suppress the production of sex steroid hormones by the gonads (28,48). Of the available GnRHa, leuprorelin acetate (LA) and triptorelin are the most commonly used, and their efficacy and safety on the treatment of CPP has been demonstrated by several studies.…”

Section: Treatment Of Central Precocious Pubertymentioning

confidence: 99%

Central precocious puberty: revisiting the diagnosis and therapeutic management

Brito

Spinola-Castro

Kochi

et al. 2016

Arch. Endocrinol. Metab.

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Clinical and laboratory diagnosis and treatment of central precocious puberty (CPP) remain challenging due to lack of standardization. The aim of this revision was to address the diagnostic and therapeutic features of CPP in Brazil based on relevant international literature and availability of the existing therapies in the country. The diagnosis of CPP is based mainly on clinical and biochemical parameters, and a period of follow-up is desirable to define the "progressive" form of sexual precocity. This occurs due to the broad spectrum of pubertal development, including isolated premature thelarche, constitutional growth and puberty acceleration, progressive and nonprogressive CPP, and early puberty. Measurement of basal and stimulated LH levels remains challenging, considering that the levels are not always in the pubertal range at baseline, short-acting GnRH is not readily available in Brazil, and the cutoff values differ according to the laboratory assay. When CPP is suspected but basal LH values are at prepubertal range, a stimulation test with short-acting or long-acting monthly GnRH is a diagnostic option. In Brazil, the treatment of choice for progressive CPP and early puberty is a long-acting GnRH analog (GnRHa) administered once a month or every 3 months. In Brazil, formulations of GnRHa (leuprorelin and triptorelin) are available and commonly administered, including 1-month depot leuprorelin 3.75 mg and 7.5 mg, 1-month depot triptorelin 3.75 mg, and 3-month depot leuprorelin 11.25 mg. Monthly or 3-month depot GnRHa are effective and safe to treat CPP. Arch Endocrinol Metab. 2016;60(2):163-72

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“…The GnRH stimulation test is the gold standard to reveal premature activation of the HPG axis in patients with precocious puberty 9 When the peak-stimulated LH levels are 5 IU/L, it is considered a pubertal response. 10 However, blood must be taken 5-8 times after the GnRH injection to determine the highest concentration of LH and FSH. As a result, this test is costly, timeconsuming and inconvenient for patients.…”

Section: Discussionmentioning

confidence: 99%

“…7 Thus, studies searching have been conducted to find a test method that will complement the GnRH stimulation test. [9][10][11][12][13][14] Some studies maintain that the repeated sampling of blood is not necessary because the pubertal state and the prepubertal state can be distinguished only with the LH concentration, obtained either at 30, 45 or 60 minutes after the GnRH stimulation. 11,12 In addition, studies on the validity of using basal LH levels to diagnose CPP have been undertaken.…”

Section: Discussionmentioning

confidence: 99%

The Utility of Basal Serum Luteinizing Hormone Levels for Screening Central Precocious Puberty in Girls

Ju¹,

Lee²,

Lee³

et al. 2013

Yeungnam Univ J Med

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Background: This study was conducted to examine if basal luteinizing hormone (LH) levels could be useful for screening central precocious puberty (CPP) in girls. Methods: A total of 90 girls under the age of 8 years were included in this study. They underwent the gonadotropin-releasing hormone (GnRH) stimulation test at Good Gang-An Hospital from March 2008 to December 2012 for evaluation of premature sexual development. Patients were classified into two groups: the pubertal response group of patients who had 5 IU/L peak LH levels in the GnRH stimulation test, and the prepubertal response group of patients who had LH levels <5 IU/L. Chronological and bone ages, height, weight, body mass index, gonadotropin response to GnRH stimulation, and basal levels of LH, follicle-stimulating hormone, and estradiol were studied in both groups. The relationship between basal LH and peak-stimulated LH was evaluated using Spearman's correlation. To determine the optimal cut-off values of basal LH levels for differentiating between two groups, the receiver operating characteristic (ROC) curves were analyzed. Results: When the correlation between basal LH levels and peak LH after GnRH stimulation was analyzed in all subjects (N=90), basal LH levels had a statistically significant positive correlation with peak stimulated LH levels (rs=0.493, p<0.001). The cut-off level of optimal basal LH was 0.1 IU/L, according to the ROC curves. Its sensitivity was 73.3%, and its specificity was 77.8%. Conclusion:The study results showed that serum basal LH levels are useful for screening CPP in girls.

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Assessment of Basal and Gonadotropin-Releasing Hormone-Stimulated Gonadotropins by Immunochemiluminometric and Immunofluorometric Assays in Normal Children

Cited by 187 publications

References 21 publications

Leuprolide Acetate 1-Month Depot for Central Precocious Puberty: Hormonal Suppression and Recovery

Leuprolide Acetate 1-Month Depot for Central Precocious Puberty: Hormonal Suppression and Recovery

Central precocious puberty: revisiting the diagnosis and therapeutic management

The Utility of Basal Serum Luteinizing Hormone Levels for Screening Central Precocious Puberty in Girls

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