Evaluation of puberty by verifying spontaneous and stimulated gonadotropin values in girls

Chin, Vivian; Cai, Ziyong; Lam, Leslie; Shah, Bina; Zhou, Ping

doi:10.1515/jpem-2014-0135

Cited by 5 publications

(6 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nevertheless, novel laboratory techniques such as tandem mass spectrometry might improve the sensitivity and specificity of estradiol assays ( 23 ). In fact, different authors have described that GnRHa-stimulated serum estradiol level at 24 h may be a useful indicator of pubertal activation, regardless of the LH values ( 21 , 24 ). However, GnRH-stimulated serum LH level provides the best clinical model due to its practicality and convenience when evaluating puberty in girls.…”

Section: Discussionmentioning

confidence: 99%

Clinical data and basal gonadotropins in the diagnosis of central precocious puberty in girls

Durá-Travé

Gallinas-Victoriano

Malumbres-Chacón

et al. 2021

Endocrine Connections

View full text Add to dashboard Cite

Objective. The objective of this study was to analyze whether some auxological characteristics or a single basal gonadotropin measurement will be sufficient to distinguish the prepubertal from pubertal status. Methods. Auxologycal characteristics were recorded and serum LH and FSH were measured by immunochemiluminescence assays before and after GnRH stimulation test in a sample of 241 Caucasian girls with breast budding between 6- to 8- years old. Peak LH levels higher than 5 IU/L were considered a pubertal response. Area under the curve, cut-off points, sensitivity, and specificity for auxologycal variables and basal gonadotropins levels were determined by receiver operating curves. Results. There were no significant differences in age at onset, weight, height, BMI and height velocity between both groups. Bone age was significantly higher in pubertal girls (p<0.05), although with limited discriminatory capacity. The sensitivity and specificity for the basal LH levels were 89% and 82% respectively, for a cut off point of 0.1 IU/L. All girls in the pubertal group had a basal LH higher than 1.0 IU/L (positive predictive value of 100%). There was a wide overlap of basal FSH and LH/FSH ratio between prepubertal and pubertal girls. Conclusions. Auxologycal characteristics should not be used only in the differential diagnosis between prepubertal from pubertal status in 6- to 8-year-old girls. We found a high specificity of a single basal LH sample and it would be useful for establishing the diagnosis of puberty in this age group, eliminating the need for GnRH stimulation testing.

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical data and basal gonadotropins in the diagnosis of central precocious puberty in girls

Durá-Travé

Gallinas-Victoriano

Malumbres-Chacón

et al. 2021

Endocrine Connections

View full text Add to dashboard Cite

show abstract

“…(Recomendación condicional | Nivel de evidencia: II OCEBM.) evidencia Los valores bajos de LH, así como la determinación basal de otros parámetros bioquímicos (FSH, estradiol/testosterona), no muestran una Sen óptima que permita excluir el diagnóstico de PPC (recomendaciones 2.3 y 2.4) [9][10][11][12][13][14][15][16][17][18][19][20][25][26][27] . Si bien no se recomienda realizar sistemáticamente la prueba de estimulación con un análogo de la hormona liberadora de gonadotropina a (GnRH) en el abordaje inicial, se debe considerar su determinación en aquellos casos de sospecha de PPC cuyas determinaciones basales de LH no sean diagnósticas (< 0.3 UI/l) y se requiera confirmar la presencia de PPC, principalmente en pacientes en quienes se considere la opción de supresión con aGnRH.…”

Section: Evidenciaunclassified

“…Otros autores han reportado una Sen del 75-94% y una Esp del 97-100% al agregar los valores de estradiol > 80 pg/ml como criterio diagnóstico a la prueba de estimulación 9,34 . Chin, et al 19 reportaron que un incremento del 27.8% en los valores del estradiol en 3-24 horas tras la prueba de estimulación muestra una Sen del 80% y una Esp del 87% para identificar PP.…”

Section: Evidenciaunclassified

“…Diversos estudios han evaluado el rendimiento diagnóstico de los valores basales de LH, planteándose distintos puntos de corte (Tabla 1) [9][10][11][12][13][14][15][16][17][18][19][20] . Algunos autores han propuesto valores bajos de LH para disminuir los falsos negativos (LH > 0.2 UI/L, Sen 91% y Esp 100%) 12 , mientras que otros han señalado que puede existir una superposición entre estadios prepuberales y puberales, con valores entre 0.3 y 0.83 UI/l 11 .…”

unclassified

See 1 more Smart Citation

Diagnóstico de pubertad precoz: Guía de práctica clínica para el diagnóstico y el tratamiento de la pubertad precoz

Miranda-Lora¹,

Torres-Tamayo²,

Zurita‐Cruz³

et al. 2020

BMHIM

View full text Add to dashboard Cite

The Mexican Society of Pediatric Endocrinology developed a clinical practice guide for the diagnosis and treatment of precocious puberty. This document presents recommendations related to the diagnosis of precocious puberty. The detailed description of the methodology for the development of this guide and the grading system, as well as the synthesis of the evidence on which it is based can be accessed in this same supplement.

show abstract

“…Central precocious puberty (CPP) is defined as activation of the hypothalamic-pituitary-gonadal axis leading to development of secondary sexual characteristics before 8 years of age in girls and 9 years in boys. The diagnosis historically required biochemical confirmation of hypothalamic-pituitary-gonadal axis activation with a gonadotropin-releasing hormone (GnRH) or GnRH analog stimulation test [1]. However, a single random luteinizing hormone (LH) level measured using an ultrasensitive (US) assay has been shown to be reliable for the diagnosis of CPP and has supplanted stimulation testing DOI: 10.1159/000513934 as first-line investigation at many centers [2,3].…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Patients with Central Precocious Puberty Who Have a Pubertal versus Prepubertal Ultrasensitive LH at Presentation

Logan

Eugster

2020

Horm Res Paediatr

View full text Add to dashboard Cite

Background: A random ultrasensitive luteinizing hormone (LH) (LH-ICMA) ≥0.3 mIU/L is highly accurate in confirming a diagnosis of central precocious puberty (CPP). However, a prepubertal value does not exclude the diagnosis. The clinical differences between patients with CPP who have a pubertal versus prepubertal LH-ICMA have not been clearly defined. Furthermore, there is minimal information regarding the utility of this test in boys with CPP. The objective of this study was to analyze differences between patients diagnosed with CPP who had a pubertal versus prepubertal LH-ICMA, including a cohort of boys. Methods: A retrospective chart review of children diagnosed with CPP within the last 10 years who had a baseline LH-ICMA obtained was performed. Variables analyzed included sex, age, ethnicity, bone age, BMI, etiology, Tanner stage (TS), testicular volume, and menarchal status. Results: Of 27 boys and 126 girls who qualified for the study, the LH-ICMA was pubertal in 87% and prepubertal in 13%. Girls with a pubertal LH-ICMA had higher baseline estradiol concentrations (p < 0.001) and more advanced breast development (p = 0.015) compared to girls with a prepubertal LH-ICMA. Of girls with a prepubertal LH-ICMA, 74% had at least TS 3 breast development and 1 was post-menarchal. The LH-ICMA was pubertal in 96% of the boys with CPP in this study. Conclusions: The LH-ICMA can be prepubertal even in girls with advanced development. To our knowledge, ours is the largest cohort of boys in whom the accuracy of a random LH-ICMA has been reported.

show abstract

Evaluation of puberty by verifying spontaneous and stimulated gonadotropin values in girls

Cited by 5 publications

References 18 publications

Clinical data and basal gonadotropins in the diagnosis of central precocious puberty in girls

Clinical data and basal gonadotropins in the diagnosis of central precocious puberty in girls

Diagnóstico de pubertad precoz: Guía de práctica clínica para el diagnóstico y el tratamiento de la pubertad precoz

A Comparison of Patients with Central Precocious Puberty Who Have a Pubertal versus Prepubertal Ultrasensitive LH at Presentation

Contact Info

Product

Resources

About