Document Detail


Long-term treatment of central precocious puberty with an intranasal LHRH analogue: control of pituitary function by urinary gonadotropins.
MedLine Citation:
PMID:  3134243     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Daily subcutaneous doses of luteinizing hormone-releasing hormone (LHRH) analogues are a well-established therapy for gonadotropin-dependent precocious puberty. Reports on intranasally administered analogues, however, are controversial. We studied the effect of intranasal D-Ser(TBU)6-LHRH(BUS) on growth rate, skeletal maturation, and urinary gonadotropins in five girls and one boy with central precocious puberty (CPP) who had been treated for 1.4-2.3 years (mean 1.9). Because of the potential antifertility effects of LHRH analogues, testicular histology was analysed in the boy. In the five children with accelerated growth, the bone age-related velocity of height gain decreased from 10.58 +/- 2.77 to 5.82 +/- 1.8 cm/year (means +/- SD, P less than 0.01), and the ratio of change in bone age to change in chronological age fell below 1. Basal luteinizing hormone (LH), and LHRH-stimulated LH and follicle stimulating-hormone, at pubertal levels before treatment, decreased significantly in all children, normalizing in four (P less than 0.04). During therapy, pituitary function was best controlled by urinary LH, which correlated with clinical data. After 13 months of therapy, testicular histology showed degenerated Sertoli cells, and absence of B- and Ap-spermatogonia and of primary spermatocytes in the boy. We conclude that: (1) Efficient long-term suppression of central precocious puberty--including accelerated growth and skeletal maturation--can be maintained by intranasal dosage of BUS. (2) Urinary LH reflects pituitary function and proves to be a reliable guide to adjustment of the LHRH-analogue dose regimen.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
J L Rime; U Zumsteg; A Blumberg; F Hadziselimovic; J Girard; R P Zurbrügg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of pediatrics     Volume:  147     ISSN:  0340-6199     ISO Abbreviation:  Eur. J. Pediatr.     Publication Date:  1988 Apr 
Date Detail:
Created Date:  1988-08-18     Completed Date:  1988-08-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7603873     Medline TA:  Eur J Pediatr     Country:  GERMANY, WEST    
Other Details:
Languages:  eng     Pagination:  263-9     Citation Subset:  IM    
Affiliation:
Wildermeth Children's Hospital, Biel, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Administration, Intranasal
Atrophy
Bone Development
Buserelin / administration & dosage,  adverse effects,  therapeutic use*
Child
Child, Preschool
Female
Gonadotropins, Pituitary / urine*
Humans
Infant
Male
Puberty, Precocious / drug therapy*,  pathology,  urine
Radioimmunoassay
Testis / pathology
Chemical
Reg. No./Substance:
0/Gonadotropins, Pituitary; 57982-77-1/Buserelin

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