Résumé
The GnRH stimulation test is the gold standard to diagnose central precocious puberty (CPP). Conventionally, we need at least 2 hours to finish the test which seems to be costly and time consuming. In this study, we described the pattern of LH and FSH levels during the GnRH test in 27 girls who presented with various degrees of precocious puberty. We found that the blood samples at 90 and 120 min after GnRH were not necessary. To save the cost of diagnosis, the basal LH/FSH ratio > 0.2, the 30 min LH/FSH ratio after GnRH > 0.9 and the peak LH/FSH ratio > 1.0 can be used to diagnose CPP with positive predictive values (PPV) of 87.3, 89.4 and 93.8 per cent respectively.
Sujets)
Enfant , Techniques de diagnostic endocrinien , Femelle , Fécondostimulants féminins/diagnostic , Hormone folliculostimulante/sang , Hormone de libération des gonadotrophines/diagnostic , Humains , Dosage radioimmunométrique , Hormone lutéinisante/sang , Puberté précoce/diagnosticRésumé
In the last two decades, the diagnosis and treatment of precocious puberty has undergone important changes. The use of supersensitive assays to determine gonadotropins and gonadal hormones has increased the sensitivity and decreased the number of blood samples required to assess the diagnosis. The introduction of gonadotropin-releasing hormone (GnRH) agonists produced a revolution in the diagnosis and treatment of this disorder. Recently, the use of long acting GnRH agonists improved the adherence of patients to medical treatment and decreased the need for uncomfortable repeated doses. The medications in the treatment of the GnRH independent causes of precocious puberty, and the important revelations in the pathophysiology of these disorders, have advanced our knowledge and management of the affected children.
Sujets)
Adolescent , Enfant , Femelle , Hormone de libération des gonadotrophines/diagnostic , Humains , Mâle , Puberté précoce/classificationRésumé
Ten Turner syndrome girls whose mean age was 10.9 +/- 2.7 years were treated with recombinant human growth hormone (rhGH), dose 0.6 U/kg/week. Five of them had classical 45, XO karyotype. The mean height velocity increased from 2.8 +/- 1.3 cm/year before treatment to 6.1 +/- 2.06 cm/year after treatment for a period of 1.4 years. The response of treatment correlated well with pretreatment height velocity (<3 cm/year) but not with karyotype. However, the response has been decreasing and an increased dose after the first year of treatment is recommended.