[Clinical application of simplified gonadotropin releasing hormone stimulating test in management of female isosexual precocious puberty].

OBJECTIVE

To explore the clinical application of simplified gonadotropin releasing hormone (GnRH) test in the management of female isosexual precocious puberty (IPP).

METHODS

Simplified GnRH stimulating test was performed in 42 girls with IPP. Thirty-eight of them were followed-up for a mean of 26 (3 - 78) months.

RESULTS

Fourteen cases showed luteinizing hormone (LH)-predominant response after GnRH stimulation, 13 showed follicle stimulating hormone (FSH)-predominant response and 15 showed no response. In the LH-predominant group, one had hypothalamic harmatoma, the other 13 were idiopathic type. Ten of them had acceleration of growth and bone prematurity. There were 8 peripheral IPP in the no response group, i.e. ovarian granulose-theca tumor 1, autonomous ovarian follicular cysts 2, McCune-Albright syndrome 2, and exogenous IPP 3. Among them, 1/2 had growth acceleration and 3/4 had bone prematurity. The remaining 7 of the no-response group and 13 with FSH-predominant response had no known etiology and were considered as transient IPP or premature thelarche based on no progression of pubertal development during follow-up. One fourth of them also showed acceleration of growth and bone prematurity.

CONCLUSION

Simplified GnRH test is helpful to objectively evaluate activation of the hypothalamic-pituitary-ovary axis, and is more reliable than those clinical features in differential etiological diagnosis of female IPP.