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Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty.
J Pediatr. 1995 Jul; 127(1):47-52.JPed

Abstract

OBJECTIVE

We assessed the utility of spontaneous and gonadotropin-releasing hormone (GnRH)-stimulated serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels measured by new immunochemiluminometric assays in the evaluation and monitoring of precocious puberty.

METHODS

We evaluated serum gonadotropin values from intravenous GnRH stimulation tests in 49 girls with clinical signs suggesting central precocious puberty (CPP). Because GnRH-stimulated LH has been considered the standard for diagnosing CPP, we used it as the basis for comparison with GnRH-stimulated FSH levels and spontaneous LH and FSH measured by immunochemiluminometric assay.

RESULTS

Twenty-six patients had a peak serum LH value above the +2 SD threshold for normal prepubertal female subjects (LH > 5 IU/L). The GnRH-stimulated FSH values had a narrow range and did not discriminate patients with CPP. In contrast, elevations in spontaneous LH and FSH were found to be specific for CPP. Spontaneous LH levels correlated strongly with peak stimulated LH levels in subjects with precocious puberty (r = 0.79) or in control subjects (r = 0.93, both p (0.0001). Spontaneous LH levels in excess of 0.1 IU/L detected true puberty with 94% sensitivity and 88% specificity. Random LH levels in excess of 0.3 IU/L had 100% specificity for CPP.

CONCLUSIONS

The GnRH-stimulated FSH levels do not adequately differentiate children with and without CPP and have limited utility in the evaluation of precocious puberty. Spontaneous FSH levels are elevated in CPP with fair sensitivity and marked specificity. Elevated random LH, measured by third-generation assay such as immunochemiluminometric assay, is strongly correlated with and highly predictive of elevated peak GnRH-stimulated LH, and is a useful screening tool for CPP.

Authors+Show Affiliations

Department of Pediatrics, Stanford University, CA 94305, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

7608810

Citation

Neely, E K., et al. "Spontaneous Serum Gonadotropin Concentrations in the Evaluation of Precocious Puberty." The Journal of Pediatrics, vol. 127, no. 1, 1995, pp. 47-52.
Neely EK, Wilson DM, Lee PA, et al. Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty. J Pediatr. 1995;127(1):47-52.
Neely, E. K., Wilson, D. M., Lee, P. A., Stene, M., & Hintz, R. L. (1995). Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty. The Journal of Pediatrics, 127(1), 47-52.
Neely EK, et al. Spontaneous Serum Gonadotropin Concentrations in the Evaluation of Precocious Puberty. J Pediatr. 1995;127(1):47-52. PubMed PMID: 7608810.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty. AU - Neely,E K, AU - Wilson,D M, AU - Lee,P A, AU - Stene,M, AU - Hintz,R L, PY - 1995/7/1/pubmed PY - 1995/7/1/medline PY - 1995/7/1/entrez SP - 47 EP - 52 JF - The Journal of pediatrics JO - J. Pediatr. VL - 127 IS - 1 N2 - OBJECTIVE: We assessed the utility of spontaneous and gonadotropin-releasing hormone (GnRH)-stimulated serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels measured by new immunochemiluminometric assays in the evaluation and monitoring of precocious puberty. METHODS: We evaluated serum gonadotropin values from intravenous GnRH stimulation tests in 49 girls with clinical signs suggesting central precocious puberty (CPP). Because GnRH-stimulated LH has been considered the standard for diagnosing CPP, we used it as the basis for comparison with GnRH-stimulated FSH levels and spontaneous LH and FSH measured by immunochemiluminometric assay. RESULTS: Twenty-six patients had a peak serum LH value above the +2 SD threshold for normal prepubertal female subjects (LH > 5 IU/L). The GnRH-stimulated FSH values had a narrow range and did not discriminate patients with CPP. In contrast, elevations in spontaneous LH and FSH were found to be specific for CPP. Spontaneous LH levels correlated strongly with peak stimulated LH levels in subjects with precocious puberty (r = 0.79) or in control subjects (r = 0.93, both p (0.0001). Spontaneous LH levels in excess of 0.1 IU/L detected true puberty with 94% sensitivity and 88% specificity. Random LH levels in excess of 0.3 IU/L had 100% specificity for CPP. CONCLUSIONS: The GnRH-stimulated FSH levels do not adequately differentiate children with and without CPP and have limited utility in the evaluation of precocious puberty. Spontaneous FSH levels are elevated in CPP with fair sensitivity and marked specificity. Elevated random LH, measured by third-generation assay such as immunochemiluminometric assay, is strongly correlated with and highly predictive of elevated peak GnRH-stimulated LH, and is a useful screening tool for CPP. SN - 0022-3476 UR - https://www.unboundmedicine.com/medline/citation/7608810/Spontaneous_serum_gonadotropin_concentrations_in_the_evaluation_of_precocious_puberty_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(95)70255-5 DB - PRIME DP - Unbound Medicine ER -