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Random luteinizing hormone often remains pubertal in children treated with the histrelin implant for central

Katherine A Lewis1, Erica A Eugster

  • 1Section of Pediatric Endocrinology, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA.

The Journal of Pediatrics
|October 9, 2012
PubMed

Insights

Random ultrasensitive luteinizing hormone (LH) monitoring in children with central precocious puberty (CPP) on histrelin implants is unreliable. Many patients show elevated LH despite effective treatment, indicating a need for revised monitoring strategies.

Area of Science:

  • Pediatric Endocrinology
  • Reproductive Medicine
  • Clinical Chemistry

Background:

  • Central precocious puberty (CPP) requires effective treatment to prevent adverse outcomes.
  • Histrelin implants are a common treatment for CPP, aiming to suppress the hypothalamic-pituitary-gonadal axis.
  • Monitoring treatment efficacy is crucial for managing CPP.

Purpose of the Study:

  • To evaluate the utility of random ultrasensitive luteinizing hormone (US LH) levels for monitoring children with CPP treated with histrelin implants.
  • To compare random US LH levels with gonadotropin-releasing hormone analog (GnRHa) stimulation tests.

Main Methods:

  • Prospective, uncontrolled, observational study at a pediatric endocrinology tertiary center.
  • Thirty-three children with CPP treated with histrelin implants were enrolled.
  • Random US LH measurements at 6 months and GnRHa stimulation tests at 12 months were performed.

Main Results:

  • In 59% of patients, 6-month random US LH levels exceeded the prepubertal range.
  • All patients who underwent GnRHa stimulation tests showed complete axis suppression (peak LH <4 IU/L).
  • US LH levels correlated with peak stimulated LH, with higher levels in those with pubertal random LH.

Conclusions:

  • Random US LH levels do not consistently revert to prepubertal ranges in over half of patients with histrelin implants and suppressed axes.
  • Current random US LH monitoring may not accurately reflect treatment efficacy in CPP.
  • Further long-term studies are necessary to establish optimal monitoring strategies for CPP treatment.
Abstract

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