True precocious puberty complicating congenital adrenal hyperplasia: Treatment with a luteinizing hormone-releasing hormone analog

O. H. Pescovitz, F. Comite, F. Cassorla, A. J. Dwyer, M. A. Poth, M. A. Sperling, K. Hench, A. McNemar, M. Skerda, Donald (Lynn) Loriaux

Research output: Contribution to journalArticle

100 Citations (Scopus)

Abstract

Congenital adrenal hyperplasia (CAH) is a recognized cause of precocious pseudopuberty. Some children with CAH also develop true precocious puberty with early maturation of the hypothalamic-pituitary-gonadal axis. We have seen 4 such children (3 boys and 1 girl) who had the diagnosis of CAH made between the ages of 3 and 6 yr. These patients were treated with standard doses of hydrocortisone and fludrocortisone. A diagnosis of true precocious puberty was made because of testicular enlargement in the boys, breast development in the girl, progressive pubic hair development, rapid growth, and rapid bone age maturation. Plasma steroid levels were elevated for age, and gonadotropin levels were within the normal pubertal range, both basally and in response to LHRH stimulation. We treated these children with daily sc injections of a LHRH analog (LHRH(a)) for 6-18 months in addition to the standard hydrocortisone and fludrocortisone therapy for CAH. LHRH(a) significantly decreased basal plasma LH and FSH, peak LH and FSH responses to native LHRH, and testosterone levels. Testis size decreased in the males, and breast development regressed in the female. LHRH(a) therapy led to significant decreases in linear growth rate, ulnar growth rate, and rate of bone age advancement. These results suggest that LHRH(a) is an effective adjunct to hydrocortisone and fludrocortisone in the treatment of true precocious puberty complicating CAH.

Original languageEnglish (US)
Pages (from-to)857-861
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume58
Issue number5
StatePublished - 1984
Externally publishedYes

Fingerprint

Precocious Puberty
Congenital Adrenal Hyperplasia
Gonadotropin-Releasing Hormone
Fludrocortisone
Hydrocortisone
Bone
Breast
Therapeutics
Plasmas
Bone Development
Growth
Gonadotropins
Growth and Development
Hair
Testosterone
Testis
Reference Values
Steroids
Bone and Bones
Injections

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

True precocious puberty complicating congenital adrenal hyperplasia : Treatment with a luteinizing hormone-releasing hormone analog. / Pescovitz, O. H.; Comite, F.; Cassorla, F.; Dwyer, A. J.; Poth, M. A.; Sperling, M. A.; Hench, K.; McNemar, A.; Skerda, M.; Loriaux, Donald (Lynn).

In: Journal of Clinical Endocrinology and Metabolism, Vol. 58, No. 5, 1984, p. 857-861.

Research output: Contribution to journalArticle

Pescovitz, OH, Comite, F, Cassorla, F, Dwyer, AJ, Poth, MA, Sperling, MA, Hench, K, McNemar, A, Skerda, M & Loriaux, DL 1984, 'True precocious puberty complicating congenital adrenal hyperplasia: Treatment with a luteinizing hormone-releasing hormone analog', Journal of Clinical Endocrinology and Metabolism, vol. 58, no. 5, pp. 857-861.
Pescovitz, O. H. ; Comite, F. ; Cassorla, F. ; Dwyer, A. J. ; Poth, M. A. ; Sperling, M. A. ; Hench, K. ; McNemar, A. ; Skerda, M. ; Loriaux, Donald (Lynn). / True precocious puberty complicating congenital adrenal hyperplasia : Treatment with a luteinizing hormone-releasing hormone analog. In: Journal of Clinical Endocrinology and Metabolism. 1984 ; Vol. 58, No. 5. pp. 857-861.
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