1. Diagnostic utility of testosterone priming prior to dynamic tests to differentiate constitutional delay in puberty from isolated hypogonadotropic hypogonadism in boys.
- Author
-
Ahmed, Shimaa Medhat Abdellatif, Badawi, Nora ElSaid, AbdElSalam, Mohamed Ahmed, Fawaz, Lubna, Kamel, AbdelKarim, and Hassan, Mona Mamdouh
- Subjects
- *
CHORIONIC gonadotropins , *DYNAMIC testing , *TESTOSTERONE , *INHIBIN , *PUBERTY , *HYPOGONADISM - Abstract
Background: Differentiation between isolated hypogonadotropic hypogonadism (IHH) and constitutional delay in puberty (CDP) throughout adolescence can be challenging for doctors. This study examines the withdrawal effects of short-term, low-dose testosterone treatment (testosterone priming) on the ability of dynamic testing to distinguish between CDP and IHH based on activation of the hypothalamo-pituitary–testicular axis. Methods: A case–control study included 20 boys with delayed puberty (group A) and 20 patients with IHH (group B). Both groups underwent Triptorelin and human chorionic gonadotropin (hCG) stimulation tests before and 2 months after testosterone injections (100 mg) intramuscularly every 4 weekly for 3 months. Results: The triptorelin-stimulated 4-h LH with a cutoff of 2.4 IU/L and the hCG-stimulated testosterone with a cutoff of 1.160 ng/mL had sensitivities of 65% each, and specificities of 90% and 95%, respectively, to diagnose CDP. After testosterone withdrawal, the cut-off values for 4-h LH were 8.850 IU/L and 3.190 ng/mL for hCG-stimulated testosterone. Basal inhibin B > 88.25 pg/ml was found to be a differentiating factor in diagnosing CDP after testosterone withdrawal. Conclusions: following the withdrawal of testosterone therapy, Inhibin B levels or 4-h stimulated LH are the most effective discriminant assays to distinguish CDP from IHH. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF