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Gonadotropin-releasing hormone analog therapy failed to improve predicted final height in two children with central
1Department of Pediatrics, Hokkaido University School of Medicine, Sapporo, Japan.
Insights
Long-acting gonadotropin-releasing hormone (GnRH) analog therapy for central precocious puberty (CPP) typically improves growth potential. However, in two children with CPP and microcephalus, GnRH analog therapy failed to suppress bone age, leading to final height deterioration.
Area of Science:
- Pediatric Endocrinology
- Neurodevelopmental Disorders
Background:
- Central precocious puberty (CPP) is often treated with long-acting gonadotropin-releasing hormone (GnRH) analogs.
- This treatment typically inhibits the pituitary-gonadal axis, suppressing premature puberty and preserving growth potential.
Observation:
- Two children diagnosed with CPP and microcephalus were treated with GnRH analog therapy.
- While pubertal development was arrested, bone age maturation was not effectively suppressed in these cases.
Findings:
- Treatment with GnRH analogs resulted in a deterioration of final height in these two patients.
- The underlying reasons for the lack of response to GnRH analog therapy in CPP with microcephalus remain unclear.
Implications:
- Microcephalus and associated minor cerebral anomalies may be linked to adverse outcomes in final height despite GnRH analog treatment.
- Careful evaluation and monitoring are crucial for children with CPP, particularly those with microcephalus, undergoing GnRH analog therapy.
Abstract:
Long-acting gonadotropin-releasing hormone (GnRH) analog treatment for central precocious puberty (CPP) suppresses excessive bone maturation by inhibiting the pituitary-gonadal axis, and usually assures favorable results for growth potential. Recently, we encountered two children with CPP and microcephalus in whom GnRH analog therapy arrested pubertal development, but could not suppress bone age maturation effectively. Eventually, their final height deteriorated rather than improved. The reason why these two cases did not respond to GnRH analog therapy remains unknown. However, microcephalus and minor cerebral anomalies may have some links to deterioration of final height. Our cases suggest that careful evaluation will be required especially for CPP with microcephalus throughout treatment with GnRH analog.