Abstract
6 girls and 1 boy(1.25-7.5 yrs at first symptoms) were treated for 1.1-2.1 yrs with intranasal LHRHa D-Ser(TBU)6EA10LHRH(buserelin), 24-46 mcg/kg/d, adjusted up to 30-80. Urinary LH and FSH (LHu, FSHu) and the response to an intranasal challenge with natural sequence LHRH were evaluated at regular intervals.
Secondary sexual characteristics regressed in 4 (1 girl afterwards excluded), stabilized in 1 and increased in 2 children. Height velocity (measurement interval 365±35 d) normalized, decreasing from 14.0 to 6.3 cm/y, always mean values, with a change of -5.6 in SDS related to chronological age(CA). During the last 6-13 mos SDS for bone age(BA) decreased in 5 children by -0.95 and stabilized in 1 girl. ΔBA/ΔCA was 2.5 after the first 6.5-13 mos and fell to 0.6 during the last 6-13 mos. Gonadotrophins: Basal LHu fell from 0.85 to 0.38 U/mmol creatinine and stimulated LHu from 1.64 to 0.3. Basal FSHu fell from 1.09 to 0.65 and stimulated FSHu from 1.81 to 0.5. Testicular biopsy after 6 mos showed partial atrophy of Leydig cells and total atrophy in 2/3 of the tubuli after 13 mos coinciding with a regression of testicular volume restored after 6 wks off therapy and dose reduction.
Intranasal buserelin is thus an effective treatment of PP in terms of puberty ratings, height velocity and bone age. Basal and LHRH-stimulated urinary LH and FSH reliably reflect pituitary suppression suitable for dose adjustments.
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Zumsteg, U., Rime, J. & Blumberg, A. LONG-TERM MANAGEMENT OF CENTRAL PRECOCIOUS PUBERTY WITH A LONG-ACTING INTRANASAL LHRH ANALOGUE(LHRHa). Pediatr Res 20, 1197 (1986). https://doi.org/10.1203/00006450-198611000-00144
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DOI: https://doi.org/10.1203/00006450-198611000-00144