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Treatment of central precocious puberty: comparison of urinary gonadotropin excretion and gonadotropin-releasing hormone (GnRH) stimulation tests in monitoring GnRH analog therapy
- Source :
- The Journal of Clinical Endocrinology & Metabolism. 81:1353-1356
- Publication Year :
- 1996
- Publisher :
- The Endocrine Society, 1996.
-
Abstract
- GnRH analogs (GnRH-a) have proven to be efficacious and have become the standard treatment for central precocious puberty (CPP). To confirm the diagnosis of CPP and to monitor the adequacy of hvpothalamic-pituitary-gonadal (HPG) axis suppression, GnRH stimulation testing has been essential. To determine whether 24-h urinary gonadotropin excretion could adequately assess HPG axis suppression, we compared the results of simultaneous GnRH stimulation tests and 24-h urinary gonadotropin determinations in 18 girls with CPP who were receiving GnRH-a therapy (leuprolide acetate, Depot-Lupron, TAP Pharmaceuticals). HPG axis suppression was defined as the absence of significant LH and FSH responses to GnRH stimulation. Simultaneous GnRH stimulation tests and urinary gonadotropin determinations had a concordance rate of 68% (42 of 62). The sensitivity and specificity of urinary LH determinations to detect inadequate HPG suppression were 75% and 64%, respectively. For urinary FSH determinations, the sensitivity and specificity were 90% and 28%, respectively. Hence, single timed urine collections lacked the sensitivity and specificity to assess HPG axis suppression and, thus, cannot replace GnRH stimulation tests for monitoring the adequacy of the GnRH-a dose.
- Subjects :
- endocrine system
medicine.medical_specialty
business.operation
medicine.drug_class
Endocrinology, Diabetes and Metabolism
Urinary system
Fluoroimmunoassay
Clinical Biochemistry
Puberty, Precocious
Tap pharmaceuticals
Stimulation
Hypothalamic–pituitary–gonadal axis
Gonadotropin-releasing hormone
Biology
Peptide hormone
Biochemistry
Gonadotropin-Releasing Hormone
Endocrinology
Internal medicine
medicine
Humans
Precocious puberty
Child
Biochemistry (medical)
Luteinizing Hormone
medicine.disease
Female
Reagent Kits, Diagnostic
Follicle Stimulating Hormone
Leuprolide
Gonadotropin
business
hormones, hormone substitutes, and hormone antagonists
Subjects
Details
- ISSN :
- 19457197 and 0021972X
- Volume :
- 81
- Database :
- OpenAIRE
- Journal :
- The Journal of Clinical Endocrinology & Metabolism
- Accession number :
- edsair.doi.dedup.....1382011b5f6168f847c188f0014339d1