Retardo puberal e hipogonadismo hipogonadotrófico: diagnóstico diferencial con la prueba de estimulación de prolactina con clorpromazina / Puberal delayed and hypogonadotrophic hypogonadism: differential diagnosis by prolactine stimulation with chlorpromazine test

ABSTRACT

We studied the changes in plasma levels of prolactin after an intramuscular injection of 0,33 mg/kg chlorpromazine and changes in plasma levels of LH and FSH after the injection of 100 µg iv GnRH in 16 patients with constitutional delayed puberty, 10 patients with hypogonadotrophic hypogonadism and 6 healthy controls. Prolactin response was significantly lower in patients with hypogonadotrophic hypogonadism compared to subjects with constitutional delayed and healthy controls ( prolactin 7.05ñ1.7, 28.9ñ2.7 and 22.0ñ3.4 ng/ml respectively). LH response to GnRH was also lower in patients with hypogonadotrophic hypogonadism, compared to the other groups ( LH 4.3ñ2.5, 13.4ñ5.4 and 17.2ñ4.8 mUI/ml respectively) however, there was a great overlapping of values. No differences between groups were observed in responses of FSH, testosterone and estrogens to GnRH. It is concluded that prolactin response to chlorpromazine is useful in the differential diagnosis of constitutional delayed puberty