IMPE Abstracts

Purpose: Gonadotropin-releasing hormone (GnRH) stimulation test is the gold standard for diagnosing central precocious puberty (CPP). However, intravenous GnRH is not always readily available. The purpose of this paper is to compare the results of gonadorelin and triptorelein used in the GnRH stimulation test in the diagnosis of CPP among girls.

Methods: A retrospective clinical study (Intravenous Gonadorelin CPP VS Subcutaneous Triptorelin CPP) comparing results used in the GnRH stimulation test. During the stimulation test with triptorelin, LH and FSH were measured at time 0, 30, 60, 120, and 180 min after the injection. With gonadorelin, LH and FSH were measured at time 0, 30, 45, 60, and 90min after the injection. Girls with peak GnRH-stimulated LH concentrations ≥5.0 IU/L were classified as having CPP. Girls with LH concentration <5.0 IU/L were classified as having precocious thelarche. Area under the curve (AUC) for triptorelin-stimulated LH concentrations was assessed using the receiver operating characteristic (ROC) analysis.

Results: Peak LH concentrations occurred after 30 min in 49% of patients, after 45 min in 46%, and after 60 min in 5.0% after stimulation with gonadorelin. LH peaked with triptorelin at 30 min in 8% 8 girls, at 60 min in 49% (n=7), at 120 min in 8%, and at 180 min in 35%. At 120 min, LH concentration 4.47 IU/L by GnRH stimulation test with triptorelin confirmed the the diagnosis of CPP with specificity of 1.00 and sensitivity 1.00.

Conclusion: The Triptorelin test had high accuracy for the differential diagnosis of CPP vs PT in girls providing a valid alternative, but take notice that peak LH concentrations appear later than godadorelin stimulation.