title: Gonadotrophin secretion pattern in anorchid boys from birth to pubertal age: pathophysiological aspects and diagnostic usefulness.
abstract: BACKGROUND
  The biphasic ontogeny of serum gonadotrophins observed in normal children also exists in girls with gonadal dysgenesis, although with higher levels. However, limited data exist in prepubertal boys with anorchia.
  
  
  OBJECTIVE
  To investigate whether the existence of testicular tissue is required for gonadotrophin downregulation in boys. Secondarily, we analysed the prevalence of high gonadotrophins and its diagnostic value to assess the presence or absence of testes in childhood.
  
  
  METHODS
  In a retrospective, semi-longitudinal study, we compared serum gonadotrophin levels in 35 boys with anorchia aged 0-18 years, in 29 bilaterally cryptorchid boys with abdominal testes and in 236 normal boys.
  
  
  RESULTS
  In anorchid boys, follicle stimulating hormone (FSH) and luteinizing hormone (LH) were abnormally high in the first months after birth, then decreased progressively. LH decreased more readily than FSH and dropped to normal values in up to 70% of anorchid patients before the usual age of pubertal onset, when both gonadotrophins increased again to very high levels. In cryptorchid boys, FSH was elevated in a significantly (P < 0·0001) lower proportion of cases. Below the age of 6 years, FSH below 2 IU/l ruled out anorchia and LH above 5 IU/l confirmed anorchia with high accuracy. Between 6 and 11 years, FSH or LH levels above 5 IU/l were highly specific for the absence of testes.
  
  
  CONCLUSIONS
  The U-shaped pattern of serum gonadotrophins observed in normal males from birth to puberty was also found in anorchid boys, but with gonadotrophin levels considerably elevated. Serum gonadotrophin levels may normalize in anorchid boys during late childhood only to rise again at puberty. The presence of testicular tissue results in restrain of gonadotrophin secretion in most patients, even if the testes are cryptorchid.
authors.affiliation: Centro de Investigaciones Endocrinológicas (CEDIE-CONICET), División de Endocrinología, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina.
authors.forename: Romina P
authors.initials: RP
authors.lastname: Grinspon
authors.forename: María G
authors.initials: MG
authors.lastname: Ropelato
authors.forename: Patricia
authors.initials: P
authors.lastname: Bedecarrás
authors.forename: Nazareth
authors.initials: N
authors.lastname: Loreti
authors.forename: María G
authors.initials: MG
authors.lastname: Ballerini
authors.forename: Silvia
authors.initials: S
authors.lastname: Gottlieb
authors.forename: Stella M
authors.initials: SM
authors.lastname: Campo
authors.forename: Rodolfo A
authors.initials: RA
authors.lastname: Rey
mesh_terms: D000293:Adolescent; D054304:Anti-Mullerian Hormone / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003456:Cryptorchidism / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D005640:Follicle Stimulating Hormone / Q000097:blood; D006061:Gonadal Dysgenesis, 46,XY / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology; D006062:Gonadotropins / Q000097:blood* / Q000378:metabolism; D006801:Humans; D007118:Immunoassay / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D011627:Puberty / Q000097:blood*; D012372:ROC Curve; D012189:Retrospective Studies; D013737:Testis / Q000002:abnormalities / Q000503:physiopathology
chemical_list: D006062:Gonadotropins; D054304:Anti-Mullerian Hormone; D005640:Follicle Stimulating Hormone