Evaluation of gonadotropin-releasing hormone stimulation test results used in the differential diagnosis of precocious puberty

Year 2021, , 26 - 31, 23.04.2021

Semih Bolu , Abdulvahit Aşık

https://doi.org/10.30569/adiyamansaglik.862593

Abstract

Aim: The purpose of this study was to evaluate the results of gonadotropin-releasing hormone (GnRH) stimulation tests administered to girls presenting with breast development before the age of eight.
Materials and Methods: Forty-nine cases (19 true precocious puberty and 30 premature thelarche) administered GnRH tests due to breast development were included in the study. Patient data were obtained through a retrospective examination of file records. Cases’ age at diagnosis, bone age (BA), and basal and gonadotropin levels hormone levels were recorded.
Results: A peak luteinizing hormone (LH) threshold of 4.58 IU/L was 84% sensitive and 90% specific in differentiating of two groups, while a peak LH/ follicle-stimulating hormone (FSH) threshold >0.27 exhibited 74% sensitivity and 80% specificity, and a BA- calendar age difference of 1.13 exhibited 63% sensitivity and 80% specificity.
Conclusion: Peak LH ≥ 4.58 IU/L and peak LH/FSH ≥0.27 threshold values can differentiate true precocious puberty and premature thelarche in girls presenting with early breast development.

Keywords

GnRH stimulation test, Peak LH/FSH, Peak LH, Premature thelarche, True precocious puberty

Erken puberte ayırıcı tanısında kullanılan gonadotropin salgılatıcı hormon uyarı test sonuçlarının değerlendirilmesi

Abstract

Amaç: Bu çalışmada 8 yaşından önce meme gelişimi ile çocuk endokrin polikliniğine başvuran kız çocuklarına uygulanan gonadotropin salgılatıcı hormon (GnRH) uyarı test sonuçlarının değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Hasta verileri dosya kayıtlarının geriye yönelik incelenmesi sonucu elde edilen bu çalışmada meme gelişimi nedeniyle GnRH uyarı testi yapılmış 49 kız olgu (19 gerçek erken puberte, 30 prematür telarş) alındı. Olguların tanı yaşı, antropometrik ölçümleri, kemik yaşı (KY), bazal ve uyarılmış gonadotropin düzeyleri kaydedildi.
Bulgular: İki grubu ayırt etmek için zirve luteinizan hormon (LH) sınır değeri 4,58 IU/L alındığında duyarlılık %84 ve özgüllük %90, zirve LH/folikül stimüle edici hormon (FSH) sınır değeri >0,27 alındığında duyarlılık %74 ve özgüllük %80, KY-takvim yaşı farkı 1,13 alındığında duyarlılık %63 ve özgüllük %80 saptandı.
Sonuç: Erken meme gelişimi ile başvuran kız çocuklarında zirve LH ≥ 4,58 IU/L ve zirve LH/FSH ≥0,27 sınır değerleri gerçek erken puberteyi prematür telarştan ayırt edebilir.

Keywords

Gerçek erken puberte, GnRH uyarı testi, Prematür telarş, Zirve LH/FSH, Zirve LH

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