Long-Term Treatment of Central Precocious Puberty with a Long-Acting Analogue of Luteinizing Hormone-Releasing Hormone. Effects on Somatic Growth and Skeletal Maturation

Mansfield, M. Joan; Beardsworth, David; Loughlin, Jacquelyn S.; Crawford, John D.; Bode, Hans H.; Rivier, J.; Vale, Wylie; Kushner, David C.; Crigler, John F.; Crowley, William F.

doi:10.1097/00006254-198409000-00017

Cited by 27 publications

(42 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…before the age of 8 years associated with a pulsatile pattern of pituitary gonadotropin secretion and a pubertal response to exogenous GnRH in the absence of any identifiable adrenal or gonadal pathology (18). The average time between the onset of breast development and the start of treatment was 9G3 months (range 4-14 months).…”

Section: Introductionmentioning

confidence: 99%

Circulating ghrelin levels in girls with central precocious puberty are reduced during treatment with LHRH analog

Maffeis

Franceschi²,

Moghetti³

et al. 2007

eur j endocrinol

View full text Add to dashboard Cite

Decreased levels of ghrelin have been measured in growing children during puberty. No data are available for girls with central precocious puberty (CPP). Aims: To explore ghrelin changes before, during, and after GnRH analog treatment in girls with CPP. Subjects and methods: A sample of 20 Caucasian girls (8.08G0.65 years of age) with CPP was recruited. Height and weight, bone age, LH, FSH, 17b estradiol (E 2 ), and ghrelin were measured before starting treatment with GnRH analog, 18 months after therapy began and again 6 months after therapy discontinuation. Results: LH and E 2 serum levels decreased significantly during treatment (2.45G2.03 vs 0.67G 0.49 UI/l, P!0.01 and 28.17G9.7 vs 15 pmol/l, P!0.01 respectively), returning to baseline levels after the discontinuation of therapy (4.75G1.66 UI/l and 29.23G6.99 pmol/l respectively). LH peaked following LHRH stimulation significantly (P!0.01) decreased during treatment (24.45G 14.17 vs 1.3G0.18 UI/l) and then increased after therapy discontinuation (12.58G6.09, P!0.01). Ghrelin decreased significantly (P!0.05) during treatment (1849G322 vs 1207G637 pg/ml), and increased, though not significantly (PZ0.09) after therapy withdrawal (1567G629 pg/ml). Conclusions:Contrary to what is expected in physiologic puberty, where ghrelin is progressively reduced, the prepubertal hormone milieau induced by GnRHa treatment in patients suffering from central precocious puberty (CPP) did not promote an increase in ghrelin circulating levels. Therefore, in CPP, ghrelin secretion seems to be independent from pubertal development per se. Concomitant estrogen suppression during treatment may play a potential role in the regulation of ghrelin secretion in these girls. European Journal of Endocrinology 156 99-103

show abstract

Section: Introductionmentioning

confidence: 99%

Circulating ghrelin levels in girls with central precocious puberty are reduced during treatment with LHRH analog

Maffeis

Franceschi²,

Moghetti³

et al. 2007

eur j endocrinol

View full text Add to dashboard Cite

show abstract

“…The treatment to counteract early puberty was gonadotrophin releasing hormone analogues(GnRHa), intranasal preparations first and depot preparations subsequently (12)(13)(14)(15)(16)(17)(18)(19). Although this treatment effectively blocked the progress of pubertal development, it was found to be associated with a decrease in height velocity as well (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

Can Bone Age Determination Provide Criteria for Growth Hormone Treatment in Adopted Girls with Early Puberty?

Proos

Lönnerholm

Jonsson

et al. 2006

Upsala Journal of Medical Sciences

View full text Add to dashboard Cite

In treatment of idiopathic central precocious puberty, GnRH analogues (GnRHa) have been accepted as the treatment of choice. Since growth velocity may be impaired with GnRHa treatment growth hormone (GH) treatment has been added in clinical trials. Recently, a study followed adopted girls with early or precocious puberty on GnRHa or combined GnRHa and GH treatment to final height. It was found that final height was significantly higher in the combined treatment group, although the difference was small. It was seen that patients that were extremely short at arrival and short at start of treatment seemed to be candidates for combined treatment. We have now analysed the data in order to define criteria for the subgroup in need of combined GnRHa-GH treatment in order to achieve normal final height, i.e. above -2 SDS.Bone ages of 46 patients at start of treatment, randomized to either GnRHa treatment or GnRHa treatment combined with GH, were examined blindly by the same radiologist and the PAH calculated. The methods according to Greulich-Pyle / Bayley-Pinneau (GP/BP) and Tanner-Whitehouse (TW2) were used. Predictions versus final height data were analysed.The accuracy of FH prediction was greatest for GnRHa treated group using the GP/BP method. The GP/BP method gave useful cut off limits for when combined treatment was necessary to possibly achieve normal height. If pre-treatment GP/PAH was > 157cm, the patients attained normal height with GnRHa treatment only. Ten out of 13 (77%) such girls could be correctly identified. Using TW2 with 117

show abstract

“…8 In 2000, the Amsterdam Clinic for Children and Adolescents initiated a protocol for the use of a GnRH analog with adolescents with GID who were at least age 12 and had reached Tanner stage 2 or 3, in doses comparable with treatment of central precocious puberty. 9 Some teenagers were older and more developed.…”

mentioning

confidence: 99%

Children and Adolescents With Gender Identity Disorder Referred to a Pediatric Medical Center

Spack¹,

Edwards-Leeper²,

et al. 2012

View full text Add to dashboard Cite

OBJECTIVES: To describe the patients with gender identity disorder referred to a pediatric medical center. We identify changes in patients after creation of the multidisciplinary Gender Management Service by expanding the Disorders of Sex Development clinic to include transgender patients. METHODS: Data gathered on 97 consecutive patients <21 years, with initial visits between January 1998 and February 2010, who fulfilled the following criteria: long-standing cross-gender behaviors, provided letters from current mental health professional, and parental support. Main descriptive measures included gender, age, Tanner stage, history of gender identity development, and psychiatric comorbidity. RESULTS: Genotypic male:female ratio was 43:54 (0.8:1); there was a slight preponderance of female patients but not significant from 1:1. Age of presentation was 14.8 ± 3.4 years (mean ± SD) without sex difference (P = .11). Tanner stage at presentation was 4.1 ± 1.4 for genotypic female patients and 3.6 ± 1.5 for genotypic male patients (P = .02). Age at start of medical treatment was 15.6 ± 2.8 years. Forty-three patients (44.3%) presented with significant psychiatric history, including 20 reporting self-mutilation (20.6%) and suicide attempts (9.3%). CONCLUSIONS: After establishment of a multidisciplinary gender clinic, the gender identity disorder population increased fourfold. Complex clinical presentations required additional mental health support as the patient population grew. Mean age and Tanner Stage were too advanced for pubertal suppressive therapy to be an affordable option for most patients. Two-thirds of patients were started on cross-sex hormone therapy. Greater awareness of the benefit of early medical intervention is needed. Psychological and physical effects of pubertal suppression and/or cross-sex hormones in our patients require further investigation.

show abstract

Long-Term Treatment of Central Precocious Puberty with a Long-Acting Analogue of Luteinizing Hormone-Releasing Hormone. Effects on Somatic Growth and Skeletal Maturation

Cited by 27 publications

References 0 publications

Circulating ghrelin levels in girls with central precocious puberty are reduced during treatment with LHRH analog

Circulating ghrelin levels in girls with central precocious puberty are reduced during treatment with LHRH analog

Can Bone Age Determination Provide Criteria for Growth Hormone Treatment in Adopted Girls with Early Puberty?

Children and Adolescents With Gender Identity Disorder Referred to a Pediatric Medical Center

Contact Info

Product

Resources

About