A single sample GnRHa stimulation test in the diagnosis of precocious puberty

Yazdani, Parvin; Lin, Yuezhen; Raman, Vandana; Haymond, Morey W.

doi:10.1186/1687-9856-2012-23

Cited by 31 publications

(33 citation statements)

References 9 publications

(13 reference statements)

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“…not been fully standardized and it is still debated which is the best procedure for such evaluation [13,14]. In this report, we performed a retrospective study to assess the usefulness of the Leuprolide ® stimulation test as a diagnostic method of idiopathic CPP in a group of girls who were evaluated for suspicion of CPP.…”

Section: The Usefulness Of the Leuprolide Stimulation Test As A Diagnmentioning

confidence: 99%

The Usefulness of the Leuprolide Stimulation Test as a Diagnostic Method of Idiopathic Central Precocious Puberty in Girls

et al. 2014

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Central precocious puberty (CPP) diagnosis is based on clinical evaluation, but hormonal evaluation is crucial. The aim of the study was to evaluate the usefulness of the leuprolide stimulation test for diagnosis of idiopathic CPP. Sixty-one girls, aged 5-8 years, were evaluated retrospectively for premature breast development. According to clinical evolution, 28 had progressive puberty and 33 nonprogressive puberty. All underwent a leuprolide stimulation test. Cutoff points, sensitivity, and specificity for gonadotropins and estradiol were determined by receiver operating characteristic (ROC) curves. Cutoff points for CPP were: baseline LH: > 0.1 mUI/l, FSH: > 2.3 mUI/l, LH/FSH ratio: > 0.23, estradiol: > 12 pg/ml; and stimulated LH: > 5.5 mUI/l, LH/FSH ratio: > 0.24, estradiol: > 79.67 pg/ml. The best diagnostic efficiency for progressive puberty were stimulated LH/FSH ratio (sensitivity: 100%, specificity 94%) followed by stimulated LH (sensitivity: 93%, specificity: 100%). Stimulated LH/FSH ratio and LH resulted in the most useful parameters for the diagnosis of CPP. Stimulated estradiol did not add more information.

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Section: The Usefulness Of the Leuprolide Stimulation Test As A Diagnmentioning

confidence: 99%

The Usefulness of the Leuprolide Stimulation Test as a Diagnostic Method of Idiopathic Central Precocious Puberty in Girls

et al. 2014

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“…Alternatively, in those children needing it, GnRHa stimulation can be efficient, definitive and brief. While it has been reported that a single sample after GnRHa stimulation test at 1 hour is sufficient to identify CPP in 88 % gonadotropin measurement at 3 h post stimulation were 100 % predictive [7], we would agree that a 30 min sample is as good as later samples for those with CPP, even though the response among those without CPP continued to rise after this time [8 • ]. This report, plus another recent report finding that either a 20 or 40 min sample was reported to be sufficient [9], adds to the growing credibility of this more efficient diagnostic approach.…”

Section: Documentation Of Pubertal Lh Secretionmentioning

confidence: 61%

Precocious Puberty and Its Treatment

Lee

Houk

2013

Curr Pediatr Rep

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Recent publications primarily relate to advances in central precocious puberty (CPP), with little new information concerning the diagnosis and treatment of peripheral precocious puberty (PPP). New information concerning CPP is centered on newer treatment options, all of which involve newer modes of delivering Gonadotropin-Releasing Hormone analog therapy. Recent publications about CPP and the association with CNS lesions, malnutrition and catch-up growth and more efficient ways to predict and document pubertal luteinizing hormone secretion will be discussed. In this article, we will review these newer developments as well as psychological issues, sexual behavior, bone mineral density and body mass index in relation to CPP and its treatment, as well as long-term outcome information on adults previously treated for CPP. Over time, additional observations have allowed a refinement of the diagnostic process, the definition of characteristics during therapy, and more verification of outcome and safety parameters. In summary, a combination of findings should be used to help document the diagnosis of CPP, and therapy should be considered when progression may cause untimely development and limited growth, while the dosing used and the best tools for monitoring therapy effectiveness remain unclear.

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“…Therefore, GnRHas have been used instead. A multitude of different protocols have been suggested, ranging from single sample LH levels to abbreviated or prolonged algorithms involving serial LH testing (19,20). Regardless of which of these tests is used, a peak stimulated LH level of ~ 4-6 mIU/L [21] or an LH/ FSH ratio >0.66 is considered pubertal by many endocrinologists [22,23].…”

Section: Laboratory Evaluationmentioning

confidence: 99%

Update on central precocious puberty: from etiologies to outcomes

Cantas-Orsdemir¹,

Eugster

2019

Expert Review of Endocrinology & Metabolism

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Introduction:Precocious puberty (PP) is one of the most common reasons for referral to pediatric endocrinologists worldwide. Gonadotropin-releasing hormone analogs (GnRHas) are the gold standard for the treatment of central precocious puberty (CPP) and have an impressive track record of safety and efficacy. However, ongoing refinements in diagnosis and management continue to lead to important advancements in clinical care. Areas Covered:The aim of this review is to cover current considerations and controversies regarding the diagnosis of CPP, as well as new findings in regards to etiology and treatment modalities. Expert Commentary:There is emerging evidence of monogenic etiologies of CPP and significant progress in the expansion of newer formulations of GnRHas. Despite these exciting developments, areas of uncertainty in the diagnosis and treatment of CPP remain. While long-term outcomes of patients treated for CPP are encouraging, only short-term follow-up is available with respect to the newer extended-release GnRHa preparations, and how they compare with historically used formulations is unknown. A particular shortage of information exists pertaining to CPP in boys and regarding the psychological implications of early puberty in girls, and more research is needed.Continued investigation will yield new insights into the underlying genetics and optimal treatment strategies for CPP.

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A single sample GnRHa stimulation test in the diagnosis of precocious puberty

Cited by 31 publications

References 9 publications

The Usefulness of the Leuprolide Stimulation Test as a Diagnostic Method of Idiopathic Central Precocious Puberty in Girls

The Usefulness of the Leuprolide Stimulation Test as a Diagnostic Method of Idiopathic Central Precocious Puberty in Girls

Precocious Puberty and Its Treatment

Update on central precocious puberty: from etiologies to outcomes

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