Abstract
The accurate assessment of LH in the peripubertal period is essential for studying the ontogeny of gonadotrophs secretion during the initiation of puberty and may also improve the differentiation between constitutional delayed puberty (COP) and isolated hypogonadism (IHH). Given the characteristically low levels of LH in these situations conventional radioimmunoassays do not have the requisite sensitivity or precision. Our aim was to study the pattern of nocturnal pulsatile LH secretion in a group of prepubertal subjects using a highly sensitive and precise LH IRMA. Fourteen patients (12M + 2F) aged 8.0-15.4 yr with delayed puberty or growth and/or short stature, and four males aged 15.2-19.8 with IHH or Kallmann's syndrome were studied by multiple blood sampling at 10 minute intervals for 12 hours between 20.00-08.00h. Pre-pubertal patients showed a wide spectrum of LH secretion from an apulsatile pattern at assay sensitivity (0.14 mU/ml) in the most immature to 4-9 puises/12h with mean nocturnal LH concentrations approaching the adult range in the late prepubertal subjects. Cross-sectionally, these 14 prepubertal subjects showed a gradual increase in nocturnal LH pulse frequency and pulse amplitude. In the 4 IHH/Kallmann's patients, 0, 0, 1 & 6 small amplitude (<0.30 mU/ml) LH pulses were observed overnight with mean nocturnal LH concentrations similar to that in the most immature of the prepubertal subjects. Despite this overlap, the improved precision in defining pulsatile LH secretion at concentrations below 1 mU/ml may facilitate the differentiation between late prepuberty and IHH/Kallmann's patients.
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Wu, F., Kelnar, C., Butler, G. et al. NOCTURNAL PULSATILE LH SECRETION IN PREPUBERTY AND HYPOGONADOTROPHIC HYPOGONADISM ASSESSED BY A HIGHLY SENSITIVE IMMUNORADIOMETRIC ASSAY (IRMA). Pediatr Res 23, 132 (1988). https://doi.org/10.1203/00006450-198801000-00185
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DOI: https://doi.org/10.1203/00006450-198801000-00185