| Title | ROLE OF GONADOTROPIN-RELEASING HORMONE AND HUMAN CHORIONIC GONADOTROPHIN STIMULATION TESTS IN DIFFERENTIATING PATIENTS WITH HYPOGONADOTROPIC HYPOGONADISM FROM THOSE WITH CONSTITUTIONAL DELAY OF GROWTH AND PUBERTY. | | Author(s) | Segal TY, Mehta A, Anazodo A, Hindmarsh PC, Dattani MT | | Institution | London Centre for Paediatric Endocrinology at Great Ormond Street Hospital for Children and University College London Hospitals, London, United Kingdom; Developmental Endocrinology Research Group, Institute of Child Health, University College London WC1N 1EH, United Kingdom. | | Source | J Clin Endocrinol Metab 2008 Nov 18. | | Abstract | Background: Delayed puberty can be due to either constitutional delay of growth and puberty (CDGP) or hypogonadotropic hypogonadism (HH). Differentiating between the two using current testing can be difficult. We assessed the utility of a GnRH test in combination with a 3-day and 19-day HCG test to discriminate between the two conditions.
Methods: A retrospective analysis of 43 boys with pubertal delay who required pubertal induction with testosterone. All were followed through puberty, and 29 were subsequently diagnosed with CDGP and 14 with HH. A standard GnRH test (2.5 microg/kg) was undertaken followed by either a short [3 day; n=38 (13 HH; 25 CDGP)], extended [19 day; n=31 (12 HH; 19 CDGP)], or both [n=27 (11 HH; 16 CDGP)] HCG stimulation test. Receiver Operating Characteristic (ROC) analysis was performed to assess the performance of the tests.
Results: Peak testosterone concentrations to both 3-day and 19-day HCG tests were significantly lower in patients with HH compared with CDGP. The 19 day test performed better than the 3-day test, and a combination of the LHRH, 3-day and 19 day HCG test [peak LH cut-off 2.8 U/l, peak 3-day testosterone cut-off 1.04 microg/l (3.6 nmol/L), peak 19 day testosterone cut-off 2.75 microg/l (9.5nmol/L)] gave a sensitivity and a specificity of 100%.
Conclusions: Our data suggest that a GnRH test in combination with both a 3-day and 19-day HCG test may aid in differentiating between CDGP and HH. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19017752 |
|
