ABSTRACT
The diagnosis of idiopathic delayed pubertal development in boys is difficult. A single GnRH test does not give information concerning hypothalamic maturity. After one week clomiphene citrate administration the LH reaction pattern is enhanced in subjects with maturing and depressed in subjects with immature hypothalamic-pituitary function.
Subject(s)
Clomiphene , Gonadotropin-Releasing Hormone , Hypothalamo-Hypophyseal System/growth & development , Puberty, Delayed/diagnosis , Adolescent , Adult , Humans , Luteinizing Hormone/blood , Male , Testosterone/bloodABSTRACT
Eight boys with severely delayed puberty without pathological cause were treated for 6 months with testosterone. This resulted in acceleration of skeletal maturation and a marked increase in height and weight. No adverse effects were found on hypothalamic-pituitary and gonadal maturation. Basal LH, FSH and testosterone levels rose to nearly adult values at follow-up within a year and pituitary responsiveness to LH-RH increased markedly.
Subject(s)
Hypogonadism/drug therapy , Puberty/drug effects , Testosterone/therapeutic use , Adolescent , Age Determination by Skeleton , Body Height/drug effects , Body Weight/drug effects , Child , Drug Evaluation , Follicle Stimulating Hormone/blood , Gonadotropin-Releasing Hormone , Humans , Luteinizing Hormone/blood , Male , Sexual Maturation/drug effects , Testis/drug effects , Testosterone/blood , Time FactorsABSTRACT
LH-RH injection and infusion studies were performed in advanced puberty, delayed puberty and hypogonadotrophic hypogonadism. No differential diagnosis could be made between delayed puberty and hypogonadotrophic hypogonadism using LH-RH injection. In the LH-RH infusion studies evidence was obtained that stimulation of the pituitary during 4 h results in continuously rising LH levels in advanced puberty and in delayed puberty while in hypogonadotrophic hypogonadism the secretory capacity of the pituitary is gradually exhausted. This phenomenon can be used in the differential diagnosis between delayed puberty and hypogonadotrophic hypogonadism. Though the FSH data point in the same direction they are not useful in this connection as the overlap between the different categories was considerable.
Subject(s)
Follicle Stimulating Hormone/blood , Gonadotropin-Releasing Hormone , Hypogonadism/blood , Luteinizing Hormone/blood , Puberty , Testosterone/blood , Adolescent , Adult , Follicle Stimulating Hormone/metabolism , Gonadotropin-Releasing Hormone/administration & dosage , Humans , Infusions, Parenteral , Injections, Intravenous , Luteinizing Hormone/metabolism , MaleABSTRACT
The differential diagnosis between hypogonadotropic hypogonadism and delayed puberty is facilitated by comparing the response of gonadotropins to LH-RH stimulation before and after administration of clomiphene citrate 200 mg daily during 7 days. Premedication of clomiphene citrate depresses peak values of LH and FSH on LH-RH in delayed puberty. In hypogonadotropic hypogonadism clomiphene citrate raises LH-RH induced peak LH while FSH does not change.
