Therapeutic strategies in a male with delayed puberty.
Therapeutical strategies in male with delayed puberty. Delayed puberty (absence of pubertal modifications after 14-15 years of age) due to transitory deficit of LHRH secretion often constitutes a difficult differential diagnostic problem for conditions of permanent LHRH deficit which can be identified only after 18 years of age in the idiopathic hypogonadotropic hypogonadism. After a period of clinical observation short-term therapy with pulsatile LHRH administration may take place. Therapy can be necessary: to document the functional integrity of the pituitary-gonadal axis; to promote pubertal modification such as to improve and physiologically sustain the patient; to tray a neuroendocrine activation of endogenous LHRH-LH secretion. Also delayed puberty linked to uremia seems to respond to short-term pulsatile LHRH administration. Pulsatile LHRH administration is the most physiological therapeutical approach to subject with delayed puberty. It seems to constitute a valid alternative to the therapy with testosterone or gonadotropins.
Giusti
M
M
DISEM, Cattedra di Endocrinologia, Università, Genova.
Valenti
S
S
Giordano
G
G
D000293:Adolescent; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006062:Gonadotropins / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D010902:Pituitary Gland / Q000503:physiopathology; D011628:Puberty, Delayed / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D013739:Testosterone / Q000008:administration & dosage / Q000627:therapeutic use; D014511:Uremia / Q000188:drug therapy / Q000503:physiopathology
D006062:Gonadotropins; D007987:Gonadotropin-Releasing Hormone; D013739:Testosterone