The hypothalamic-pituitary-gonadal axis is active in humans during early infancy. The growth of hemangiomas accelerates during infancy and may be affected by serum estradiol or gonadotropin levels. We have examined this axis in ten female infants under six months of age with orbital hemangiomas receiving corticosteroid therapy in the presence (n=7) or absence (n=3) of the GnRH analog, depot Leuprolide (TAP Pharm.) as a suppressor of central gonadotropin production. Estradiol levels were obtained and GnRH stimulation tests were administered to assess gonadotropin secretion. The gonadotropin response to GnRH stimulation in the first year of life revealed elevated Luteinizing Hormone (LH) and Follicle-stimulating Hormone (FSH) levels with a predominant FSH pattern. Serum estradiol levels were elevated during the neonatal period and decreased at a constant rate despite persistent elevation of gonadotropin secretion. Interestingly, infants required twice the dose and frequency of administration to achieve gonadotropin suppression (i.e., 15 mg every 2 weeks). The rate of decrease of serum estradiol levels was not affected significantly by Leuprolide administration compared to untreated infants. However, LH and FSH were suppressed within two weeks of initiation of therapy. Discontinuation of Leuprolide resulted in reversal of central suppression. There were no physical or biochemical side effects noted during Leuprolide therapy. Some infants showed a significant decrease in orbital astigmatism and reduction of the hemangioma with Leuprolide therapy.

(Funded by TAP Pharm.)