title: Significant adverse reactions to long-acting gonadotropin-releasing hormone agonists for the treatment of central precocious puberty and early onset puberty.
abstract: OBJECTIVE
  Long-acting gonadotropin-releasing hormone agonists (GnRHa) are commonly used to treat central precocious puberty (CPP) in Korea. Although rare, there have been reports on the characteristic of adverse reactions of GnRHa in CPP among the Korean population. This study was intended to report on our clinical experience regarding significant adverse reactions to long-acting GnRHa in CPP and early onset puberty and to evaluate the prevalence rate of serious side effects.
  
  
  METHODS
  This retrospective study included children with CPP and early onset puberty, who were administered monthly with long-acting GnRHa (leuprolide acetate, triptorelin acetate) at the outpatient clinic of Department of Pediatrics, at Inha University Hospital, between January 2011 and December 2013. We analyzed the clinical characteristics of patients who experienced significant adverse reactions and evaluated the prevalence rate.
  
  
  RESULTS
  Six serious side effects (0.9%) were observed among total of 621 CPP and early onset puberty children with GnRHa therapy. The number of sterile abscess formation was four in three patients (4 events of 621). Anaphylaxis occurred in only one patient, and unilateral slipped capital femoral epiphysis (SCFE) in another one patient. Anaphylaxis occurred after the 6th administration of the monthly depot triptorelin acetate. Unilateral SCFE developed in GnRHa therapy.
  
  
  CONCLUSIONS
  Sterile abscess formation occurred in 0.6% of CPP and early onset puberty patients from the administration of a monthly depot GnRHa therapy. The occurrences of anaphylaxis and SCFE are extremely rare, but can have serious implications on patients. Clinicians should be aware of these potential adverse effects related to GnRHa therapy in CPP.
authors.affiliation: Department of Pediatrics, Inha University Hospital, Grauduate School of Medicine, Inha University, Incheon, Korea.
authors.forename: Ji Woo
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Pediatrics, Inha University Hospital, Grauduate School of Medicine, Inha University, Incheon, Korea.
authors.forename: Hyung Jin
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Surgery, Inha University Hospital, Grauduate School of Medicine, Inha University, Incheon, Korea.
authors.forename: Yun Mee
authors.initials: YM
authors.lastname: Choe
authors.affiliation: Department of Pediatrics, Inha University Hospital, Grauduate School of Medicine, Inha University, Incheon, Korea.
authors.forename: Hee Suk
authors.initials: HS
authors.lastname: Kang
authors.affiliation: Department of Pediatrics, Inha University Hospital, Grauduate School of Medicine, Inha University, Incheon, Korea.
authors.forename: Soon Ki
authors.initials: SK
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Inha University Hospital, Grauduate School of Medicine, Inha University, Incheon, Korea.
authors.forename: Yong Hoon
authors.initials: YH
authors.lastname: Jun
authors.affiliation: Department of Pediatrics, Inha University Hospital, Grauduate School of Medicine, Inha University, Incheon, Korea.
authors.forename: Ji Eun
authors.initials: JE
authors.lastname: Lee
keywords: Central precocious puberty; Drug-related side effects and adverse reactions; Leuprolide; Triptorelin