Predictive value of serum follicle-stimulating hormone levels in the differentiation between hypogonadotropic hypogonadism and constitutional delay of puberty.
OBJECTIVE
Gonadotropin secretion was evaluated to predict hypogonadotropic hypogonadism (HH) in 36 children suspected of having HH.


METHODS
LH was measured for 24 h at 10-min intervals, and FSH and estradiol or testosterone at 1-hour intervals. Twenty boys (age 15.7, range 13.2-19.3 years) and 16 girls (age 16.1, range 13.0-20.6 years) were studied.


RESULTS
LH pulses were detected in 9 boys and 5 girls. HH was confirmed in all 11 LH apulsatile boys and in 8 of 11 LH apulsatile girls. Random FSH values of < or =1.11 and < or =2.86 IU/l in boys and girls, respectively, discriminated patients with LH pulses from patients without (sensitivity for lack of LH pulses 97 and 100%, respectively). In boys testicular volume was not discriminatory. In 1 girl LH pulses were observed without estradiol production, suggesting LH neurosecretory dysfunction.


CONCLUSIONS
Low FSH levels in adolescence are strongly related to a lack of LH pulses. Lack of LH pulses is highly suspect for HH. FSH may be a tool in the differentiation between HH and delayed puberty.
Odink
R J
RJ
Department of Pediatrics, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands.
Schoemaker
J
J
Schoute
E
E
Herdes
E
E
Delemarre-van de Waal
H A
HA
D000293:Adolescent; D000328:Adult; D003937:Diagnosis, Differential; D004958:Estradiol / Q000378:metabolism; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood* / Q000378:metabolism; D005500:Follow-Up Studies; D006062:Gonadotropins / Q000172:deficiency* / Q000502:physiology; D006801:Humans; D007006:Hypogonadism / Q000175:diagnosis / Q000503:physiopathology*; D007986:Luteinizing Hormone / Q000378:metabolism; D008297:Male; D011237:Predictive Value of Tests; D011628:Puberty, Delayed / Q000175:diagnosis / Q000503:physiopathology*; D013739:Testosterone / Q000378:metabolism
D006062:Gonadotropins; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone