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Resumption of Puberty After Long Term Luteinizing Hormone-Releasing Hormone Agonist Treatment of Central Precocious Puberty

PENELOPE K. MANASCO

1

Developmental Endocrinology Branch, National Institute of Child Health and Human Development, and the Clinical Center (K.D.H., J.J., S.C.H.), National Institutes of Health Bethesda, Maryland 20892; The Department of Pediatrics, University of Minnesota (O.H.P.) Minneapolis, Minnesota 55455

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PENELOPE K. MANASCO

ORA H. PESCOVITZ

1

Developmental Endocrinology Branch, National Institute of Child Health and Human Development, and the Clinical Center (K.D.H., J.J., S.C.H.), National Institutes of Health Bethesda, Maryland 20892; The Department of Pediatrics, University of Minnesota (O.H.P.) Minneapolis, Minnesota 55455

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ORA H. PESCOVITZ

PENELOPE P. FEUILLAN

1

Developmental Endocrinology Branch, National Institute of Child Health and Human Development, and the Clinical Center (K.D.H., J.J., S.C.H.), National Institutes of Health Bethesda, Maryland 20892; The Department of Pediatrics, University of Minnesota (O.H.P.) Minneapolis, Minnesota 55455

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PENELOPE P. FEUILLAN

KAREN D. HENCH

1

Developmental Endocrinology Branch, National Institute of Child Health and Human Development, and the Clinical Center (K.D.H., J.J., S.C.H.), National Institutes of Health Bethesda, Maryland 20892; The Department of Pediatrics, University of Minnesota (O.H.P.) Minneapolis, Minnesota 55455

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KAREN D. HENCH

KEVIN M. BARNES

1

Developmental Endocrinology Branch, National Institute of Child Health and Human Development, and the Clinical Center (K.D.H., J.J., S.C.H.), National Institutes of Health Bethesda, Maryland 20892; The Department of Pediatrics, University of Minnesota (O.H.P.) Minneapolis, Minnesota 55455

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KEVIN M. BARNES

JANET JONES

1

Developmental Endocrinology Branch, National Institute of Child Health and Human Development, and the Clinical Center (K.D.H., J.J., S.C.H.), National Institutes of Health Bethesda, Maryland 20892; The Department of Pediatrics, University of Minnesota (O.H.P.) Minneapolis, Minnesota 55455

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JANET JONES

SUVIMOL C. HILL

1

Developmental Endocrinology Branch, National Institute of Child Health and Human Development, and the Clinical Center (K.D.H., J.J., S.C.H.), National Institutes of Health Bethesda, Maryland 20892; The Department of Pediatrics, University of Minnesota (O.H.P.) Minneapolis, Minnesota 55455

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SUVIMOL C. HILL

D. LYNN LORIAUX

1

Developmental Endocrinology Branch, National Institute of Child Health and Human Development, and the Clinical Center (K.D.H., J.J., S.C.H.), National Institutes of Health Bethesda, Maryland 20892; The Department of Pediatrics, University of Minnesota (O.H.P.) Minneapolis, Minnesota 55455

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D. LYNN LORIAUX

GORDON B. CUTLER, JR.

1

Developmental Endocrinology Branch, National Institute of Child Health and Human Development, and the Clinical Center (K.D.H., J.J., S.C.H.), National Institutes of Health Bethesda, Maryland 20892; The Department of Pediatrics, University of Minnesota (O.H.P.) Minneapolis, Minnesota 55455

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GORDON B. CUTLER, JR.

The Journal of Clinical Endocrinology & Metabolism, Volume 67, Issue 2, 1 August 1988, Pages 368–372, https://doi.org/10.1210/jcem-67-2-368

Published:

01 August 1988

Article history

Received:

12 January 1988

Abstract

To determine whether puberty resumes normally after long term LHRH agonist (LHRHa) treatment, we studied 16 children with central precocious puberty treated with LHRHa (d-Trp⁶,Pro⁹,NEt-LHRH) for 1–4 yr (mean, 3.3 yr). Treatment was discontinued at a mean age of 11.6 ± 1.3 (±sd) yr. Plasma hormone levels, growth velocity, rate of bone maturation, and pubertal stage were assessed at the end of treatment and 3 and 12 months later.

Basal plasma sex steroid and basal and LHRH-stimulated gonadotropin levels returned to near-pretreatment levels 3 months after discontinuation of therapy and were fully restored to pretreatment levels at 12 months. Growth velocity, which had been 7.8 cm/yr before treatment, was stable after discontinuation of treatment at approximately 2.6 cm/yr. The predicted height, which had increased during treatment (P < 0.01), remained stable at approximately 5 cm above the pretreatment predicted height. The rate of bone age advancement (Δbone age/Δchronological age) increased gradually from 0.4 at the end of treatment to the normal value of 0.9 12 months posttreatment. Breast and pubic hair pubertal stages, which were stable throughout treatment and were 4.0 ± 0.8 (±sd) and 3.6 ± 1.0 at the end of treatment, increased to 4.9 ± 0.2 and 4.5 ± 1.0. This approximated the normal rate of 1 stage/yr. Menses occurred in 8 of 12 girls within 1 yr after treatment and in an additional 3 by 20 months after treatment. Six of the girls had menstruated before treatment, and all of these menstruated within 14 months after discontinuing therapy.

We conclude that gonadotropin and sex steroid secretion and the clinical progression through puberty appear to resume normally after discontinuation of long term LHRHa treatment of central precocious puberty. Long term follow-up will be required, however, to determine whether the improvement in predicted height of these patients will be achieved, and whether adult reproductive function will be normal

Copyright © 1988 by The Endocrine Society

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