title: Monitoring gonadotropin-releasing hormone analogue (GnRHa) treatment in girls with central precocious puberty: a comparison of four methods.
abstract: OBJECTIVE
  The objective of this study was to validate basal, post-gonadotropin-releasing hormone analogue (post-GnRHa) and first-voided urinary LH (ULH) as alternatives to an LHRH stimulation test in monitoring treatment efficacy in central precocious puberty (CPP).
  
  
  METHODS
  Seventeen girls with CPP were followed over 22.5±9.1 months during GnRHa (triptorelin) treatment. ULH and post-GnRHa LH levels were obtained every 4 months before and 24 h after GnRHa administration, respectively, along with clinical and bone age (BA) evaluation. LHRH stimulation tests were performed annually.
  
  
  RESULTS
  A total of 36 LHRH stimulation tests demonstrated adequate suppression with a peak LH of 0.57±0.33 IU/L. The corresponding basal LH was 0.27±0.16 IU/L. Ninety post-GnRHa LH measurements were similar to LHRH-stimulated LH levels (0.56±0.31 IU/L), whereas 8% of ULH levels were above prepubertal threshold. Fourteen episodes of growth acceleration and ten episodes of BA advancement resolved without treatment modification.
  
  
  CONCLUSIONS
  Suppressed basal and post-GnRHa LH levels indicate adequate suppression of puberty. Clinical breakthroughs during treatment are transient and resolved spontaneously.
authors.forename: Amnon
authors.initials: A
authors.lastname: Zung
authors.forename: Ella
authors.initials: E
authors.lastname: Burundukov
authors.forename: Mira
authors.initials: M
authors.lastname: Ulman
authors.forename: Tamar
authors.initials: T
authors.lastname: Glaser
authors.forename: Zvi
authors.initials: Z
authors.lastname: Zadik
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D015415:Biomarkers / Q000032:analysis*; D001846:Bone Development / Q000187:drug effects*; D001940:Breast / Q000187:drug effects / Q000254:growth & development; D002648:Child; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D043373:Follicle Stimulating Hormone, Human / Q000032:analysis; D005500:Follow-Up Studies; D006801:Humans; D007986:Luteinizing Hormone / Q000032:analysis; D011379:Prognosis; D011629:Puberty, Precocious / Q000188:drug therapy* / Q000378:metabolism* / Q000473:pathology; D017329:Triptorelin Pamoate / Q000627:therapeutic use*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D015415:Biomarkers; D043373:Follicle Stimulating Hormone, Human; D017329:Triptorelin Pamoate; D007986:Luteinizing Hormone