Concentrations of Plasma Luteinizing Hormone in Infants, Children, and Adolescents with Normal and Abnormal Gonadal Function

Abstract

ExtractThis communication reports the development of a sensitive, reproducible, and specific radioimmunoassay for luteinizing hormone (LH) in plasma and the application of this method to a cross-sectional survey of plasma LH concentratior~s in 243 infants, children, and adolescents with normal and abnormal growth and sexual development. One nanogram of Hartree purified human pituitary LH standard was immunologically equivalent to 13.7 mIU of the Second International Reference Preparation of Human Menopausal Gonadotropin. The lower limit of sensitivity of the assay varied between 0.025 and 0.05 ng/ml. Specimens of plasma containing t0.25 ng/ml (t3.7 mIU/ml) have been considered indistinguishable from 'zero'.Plasma LH concentrations increased after 9 years of age in normal boys and after 6 years of age in normal girls. In males with constitutional delay in growth and development, LH levels were generally lower than in normal boys of comparable ages (figs. 3 and 4). The plasma LH concentration also increased with advancing sexual maturation ( fig. 5).Levels of LH were t0.25 nglml in 15 of 18 males (6-20 years old) and in 10 of 11 females (6-19 years old) with hypopituitarism and documented lack of human growth hormone response to hypoglycemia. In three such patients, plasma LH concentrations correlated with their degrees of sexual maturation, but in a 16-year-old clinically prepubertal male, patient SA, with hypopituitarism secondary to a craniopharyngioma, LH levels higher than normal male values were noted.Plasma LH concentrations were 1.2 and 1.45 ng/ml in 2 of 3 girls less than 4 years old, with gonadal dysgenesis, and ranged between 0.33 and 3.6 ng/ml in 10 of 15 older patients with this diagnosis (table 111). The plasma LH concentration was 1.7 ng/ml in a 3-month-old male ~seudohermaphrodite. Plasma LH concentrations ranged between 0.38 and 0.88 ng/ml in five of seven children with true sexual precocity. In 13 of 15 girls with precocious thelarche, and in all of 10 patients with premature pubarche, LH levels were t0.25 ng/ml. The intravenous infusion of conjugated equine estrogens was followed by a prompt decline in plasma LH levels in patients with gonadal dysgenesis and Klinefelter's syndrome, but failed to alter significantly LH values in patient SA ( fig. 6 A, B, C). Administration of clomiphene citrate and cisclomiphene citrate increased plasma LH concentrations in normal males, but failed to do so in patients with hypopituitarism, including patient SA ( fig. 7 A, B). The intramuscular administration of medroxyprogesterone acetate was associated with suppression of plasma LH levels in two patients with true sexual precocity ( fig. 8). ROOT, MOSHANG, BONGIOVANNI and EBERLEIN SpeculationThe hypothalamic-pituitary-gonadal axis is active in the prepubertal human subject, and is responsive to abnormal function in one segment of the system.

Correlation of serum follicular stimulating hormone (FSH) and luteinizing hormone (LH) as measured by radioimmunoassay in disorders of sexual development

“…Serums were also obtained from 93 normal females (ages 2-31 yr), 71 normal males (ages [5][6][7][8][9][10][11][12][13][14][15][16][17][18] yr), and 12 hypopituitary patients (ages 13-25 yr). The LH concentrations in some of these individuals were reported previously (1), as were the radioimmunoassay techniques for determining FSH and LH (2)(3)(4)(5)(6)(7)(8)(9).…”

Excretion of Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) in Urine by Pubertal Girls

“…Their data indicate that mean LH and FSH levels in serum show significant elevations 24 hr before ovulation. Previous studies [16,23,24,28] have shown the corand girls and their stage of sexual development. It has further been demonstrated that the rise in urinary excretion of FSH and LH, as measured by the techniques employed in this work, correlates favorably with the progressing stage of sexual development in males [2,25).…”

Serum Follicular-Stimulating Hormone and Luteinizing Hormone as Measured by Radioimmunoassay Correlated with Sexual Development in Hypopituitary Subjects

“…In this regard, it is of interest to note the serum LH concentrations (13.5, 19.6 mIU/ml) of the two 15 yr old females in stage III (Table IV). Root, Moshang, Bongiovanni, and Eberlein have indicated that a 17 yr old female with idiopathic hypopituitarism who had a serum LH concentration of 13.7 mIU/ ml attained sexual maturity (13).…”