Abstract
The laboratory diagnosis of true puberty (Tpp) relies on LH response to GnRh administration (ΔLH ≥ 15mIU/ml in our laboratory) and nocturnal LH secretion. Nevertheless, some patients with TPP may have prepubertal ΔLH on the GnRH test, We compared the 24 h, LH and FSH secretion with the GnRH test in 4 girls with TPP (cases 1-4), 1 girl with previous ovarian cyst (case 5) and 1 girl with premature pubarche (case 6). Blood was drawn every 20 min (vol < 7/ml/Kg/24hs) through an I.v. catheter; m^als, daily activities and nocturnal sleep were maintained. LH and FSH determinations were done in duplicate, in the same assay, and pulses were analysed by the algorithm-DETECT method in an IBM-PC compatible computer. Diurnal period was 8-20 hs and nocturnal 20:20- 7:40 hs. Basal estradiol levels were below sensitivity of the assay (<10 pg/ml) throughout the 24 hs.
A predominance of nocturnal LF secretion (area and number of pulses) was observed in 3 patients with TPP. The 2 patients with TPP and ΔLH <15 mIU/ml also had predominant nocturnal LH secretion. Cases 1 and 2 with TPP had ΔLH>15 mIU/ml and case 1 with a pubertal ΔLH had the lowest area under LH pulses, even lower than the patient with premature pubarche. We concluded that analysis of 24h. LH and FSH secretion did not offer a definitive method for diagnosis of TPP due to the heterogeneity of gonadotropin secretion.
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Domenice, S., Mendonca, B., Villares, S. et al. 24 HOUR LH AND FSH SECRETION AND RESPONSE TO GNRH IN GIRLS WITH SEXUAL PRECOCITY. Pediatr Res 28, 421 (1990). https://doi.org/10.1203/00006450-199010000-00037
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DOI: https://doi.org/10.1203/00006450-199010000-00037