title: Predictive value of serum follicle-stimulating hormone levels in the differentiation between hypogonadotropic hypogonadism and constitutional delay of puberty.
abstract: 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.
authors.affiliation: Department of Pediatrics, Academic Hospital Vrije Universiteit, Amsterdam, The Netherlands.
authors.forename: R J
authors.initials: RJ
authors.lastname: Odink
authors.forename: J
authors.initials: J
authors.lastname: Schoemaker
authors.forename: E
authors.initials: E
authors.lastname: Schoute
authors.forename: E
authors.initials: E
authors.lastname: Herdes
authors.forename: H A
authors.initials: HA
authors.lastname: Delemarre-van de Waal
mesh_terms: 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
chemical_list: D006062:Gonadotropins; D013739:Testosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone