The effects of gonadotropin releasing hormone analogue therapy on girls with gonadotropin-dependent precocious puberty.
OBJECTIVE
It has been reported that gonadotropin releasing hormone analogue (GnRHa) therapy can improve the adult height of patients with gonadotropin-dependent precocious puberty. The purpose of this study was to evaluate the effect of GnRHa on the adult height of girls with gonadotropin-dependent precocious puberty and the adverse effects of such therapy.


METHODS
Between 1989 and 2006, 11 girls with gonadotropin-dependent precocious puberty who had been treated with GnRHa and reached their adult height were enrolled in the present study. Follow-up studies of bone age, pelvic sonography and GnRH test were done regularly during the period of treatment. All patients had bone mineral density examined at least 2 years after completion of GnRHa therapy.


RESULTS
GnRHa therapy was initiated at the age of 8.0 +/- 1.5 years. The predicted adult height immediately before GnRHa therapy was 146.7 +/- 4.8 cm (-2.3 +/- 0.9 standard deviation [SD]). The duration of GnRHa therapy was 4.7 +/- 1.8 years. The adult height of the patients was 156.3 +/- 4.3 cm (-0.6 +/- 0.8 SD), which is similar to their target height of 157.0 +/- 4.5 cm (-0.5 +/- 0.8 SD). The uterine sizes and gonadotropin responses to GnRH stimulation were well suppressed during treatment. Menstruation resumed 9.2 +/- 5.9 months after the discontinuation of treatment in these patients. Forty-five percent of patients had lumbar bone mineral density less than 1 SD below that of normal young Taiwanese adults in the Taipei region.


CONCLUSIONS
GnRHa therapy can improve the adult height of patients with gonadotropin-dependent precocious puberty. However, 45% of patients had decreased bone accretion during therapy.
Tung
Yi-Ching
YC
Department of Pediatrics, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan.
Lee
Jing-Sheng
JS
Tsai
Wen-Yu
WY
Hsiao
Pei-Hung
PH
D000293:Adolescent; D001827:Body Height; D015519:Bone Density; D002648:Child; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists; D006062:Gonadotropins / Q000378:metabolism; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D008186:Luteolytic Agents / Q000627:therapeutic use*; D008598:Menstruation; D011629:Puberty, Precocious / Q000188:drug therapy* / Q000378:metabolism; D017329:Triptorelin Pamoate / Q000627:therapeutic use*
D006062:Gonadotropins; D008186:Luteolytic Agents; D017329:Triptorelin Pamoate; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide