Effects of GnRH analogue treatment on anterior pituitary hormones in children with central precocious puberty
-
Havva Nur Peltek Kendirci
, Sebahat Yılmaz Ağladıoğlu
, Aşan Önder , Veysel Nijat Baş , Semra Çetinkaya and Zehra Aycan
Abstract
Introduction and purpose: This study aims to investigate the effect of Gonadotropin-releasing hormone analogues (GnRHa) treatment on anterior pituitary hormones in female children with central precocious puberty (CPP).
Subjects and method: There were 62 female children who had been diagnosed with CPP and received GnRHa (Leuprolide acetate, 3.75 mg intramuscular/subcutaneous/28 days) included in the study. All subjects were clinically evaluated prior to treatment and every 3 months during treatment with serum LH, FSH, ACTH, TSH, PRL as pituitary hormones, and the end hormones such as plasma E2, cortisol, fT3, fT4 levels were measured. IGF-1 and IGFBP-3 levels were measured, and SDS was evaluated according to age and gender.
Results: Prolactin levels were higher during GnRHa treatment compared to pre-treatment values although the increase was statistically significant only at month 3. In addition, while 2 (3.2%) of the patients had hyperprolactinemia before treatment, 11 (17.7%) patients developed hyperprolactinemia at different time points during treatment.
Conclusion: This study concluded that GnRHa treatment resulted in hyperprolactinemia and had no significant effect other pituitary hormones.
References
1. Massart F, Parrino R, Placidi G, Massai G, Federico G, et al. Prolactin secretion before, during, and after chronic gonadotropin-releasing hormone agonist treatments in children. Fertil and Steril 2005;84:719–24.10.1016/j.fertnstert.2005.03.041Search in Google Scholar
2. Toumba M, Kokotsis V, Savva SC, Skordis N. Expensive therapies in children: benefit versus cost of combined treatment of recombinant human growth hormone and gonadotropin-releasing hormone analogue in girls with poor height potential. J Pediatr Endocrinol Metab 2014;27:311–6.10.1515/jpem-2013-0210Search in Google Scholar
3. Neely EK, Hintz RL, Wilson DM, Lee PA, Gautier T, et al. Normal ranges for immunochemiluminometric gonadotropin assays. J Pediatr 1995;127:40–6.10.1016/S0022-3476(95)70254-7Search in Google Scholar
4. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child 1969;44:291–303.10.1136/adc.44.235.291Search in Google Scholar
5. Neyzi O, Günöz H, Furman H. Turkish children’s body weight, length, head circumference and body mass index reference values. Turkısh Pediatr J 2008;51:1–14.Search in Google Scholar
6. Bhatia S, Neely EK, Wilson DM. Serum luteinizing hormone rises within minutes after depot leuprolide injection: implications for monitoring therapy. Pediatrics 2002;109:30–6.10.1542/peds.109.2.e30Search in Google Scholar
7. Lee PA, Page J. The Leuprolide Study Group. Effects of leuprolide in the treatment of central precocious puberty. J Pediatr 1989;115:321–4.Search in Google Scholar
8. Kappy MS, Ganong CS. Advances in the treatment of precocious puberty. Adv Pediatr 1994;41:223–61.Search in Google Scholar
9. Lawson ML, Cohen N. A single sample subcutaneous luteinizing hormone (LH)- releasing hormone (LHRH) stimulation test for monitoring LH suppression in children with central precocious puberty receiving LHRH agonists. J Clin Endocrinol Metab 1999;84:4536–40.Search in Google Scholar
10. Eren E, Yapıcı Ş, Çakır ED, Ceylan LA, Sağlam H, et al. Clinical course of hyperprolactinemia in children and adolescents: a review of 21 cases. J Clin Res Pediatr Endocrinol 2011;3:65–9.10.4274/jcrpe.v3i2.14Search in Google Scholar
11. Rosenbloom AL, Connor EL. Hypopituitarism and other disorders of the growth hormone-insulin like growth factor-I axis. In: Lifshitz F, editor. Pediatric endocrinology, 5th ed. New York: Informa Healtcare USA, 2007;65–99.Search in Google Scholar
12. Elmlinger MW, Kühnel W, Weber MM, Ranke MB. Reference ranges for two automated chemiluminescent assays for serum insulin-like growth factor I (IGF-I) and IGF-binding protein 3 (IGFBP-3). Clin Chem Lab Med 2004;42:654–64.10.1515/CCLM.2004.112Search in Google Scholar
13. Kapelari K, Kirchlechner C, Högler W, Schweitzer K, Virgolini I, et al. Pediatric reference intervals for thyroid hormone levels from birth to adulthood: a retrospective study. BMC Endocr Disord 2008;8:15–27.10.1186/1472-6823-8-15Search in Google Scholar
14. Matzkin H, Kaver I, Lewyshon O, Ayalon D, Braf Z. The role of increased prolactin levels under GnRH analogue treatment in advanced prostatic carcinoma. Cancer 1988;61:2187–91.10.1002/1097-0142(19880601)61:11<2187::AID-CNCR2820611109>3.0.CO;2-7Search in Google Scholar
15. Siegel YI, Korczak D, Lindner A. Serum prolactin levels in patients treated with a gonadotropin-releasing hormone analogue for adenocarcinoma of the prostate. Eur Urol 1991;19:16–8.10.1159/000473571Search in Google Scholar
16. Sklar CA, Rothenberg S, Blumberg D, Oberfield SE, Levine LS, et al. Suppression of the pituitary-gonadal axis in children with central precocious puberty: effects on growth, growth hormone, insulin-like growth factor-I, and prolactin secretion. J Clin Endocrinol Metab 1991;73:734–8.10.1210/jcem-73-4-734Search in Google Scholar
17. Kauschansky A, Nussinovitch M, Frydman M, Yeshaya A, Ben-Rafael Z. Hyperprolactinemia after treatment of long-acting gonadotropin-releasing hormone analogue Decapeptyl in girls with central precocious puberty. Fertil Steril 1995;64:285–7.10.1016/S0015-0282(16)57724-3Search in Google Scholar
18. Samson WK, Keown C, Samson CK, Samson HW, Lane B, et al. Prolactin-releasing peptide and its homolog RFRP-1 act in hypothalamus but not in anterior pituitary gland to stimulate stress hormone secretion. Endocrine 2003;20:59–66.10.1385/ENDO:20:1-2:59Search in Google Scholar
19. Seal LJ, Small CJ, Dhillo WS, Kennedy AR, Ghatei MA, et al. Prolactin- releasing peptide releases corticotropin-releasing hormone and increases plasma adrenocorticotropin via the paraventricular nucleus of the hypothalamus. Neuroendocrinology 2002;76:70–8.10.1159/000064427Search in Google Scholar
20. Wilson EE, Lıttle BB, Byrd W, Mcgee E, Carr BR. The effect of Gonadotropin-Releasing Hormone Agonists on adrenocorticotropin and cortisol secretion in adult premenopasual women. J Clin Endocrinol Metab 1993;76:162–4.Search in Google Scholar
21. Miller WL, Achermann JC, Flück CE. The adrenal cortex and its disorders. In: Sperling MA, editor. Pediatric endocrinology, 3rd ed. Philadelphia: Saunders & Elsevier Inc., 2008:444–511.Search in Google Scholar
22. Grinspoon SK, Biller BM. Clinical review 62: laboratory assessment of adrenal insufficiency. J Clin Endocr Metab 1994;79:923–31.Search in Google Scholar
23. Chantilis SJ, Barnett-Hamm C, Byrd WE, Carr BR. The effect of gonadotropin- releasing hormone agonist on thyroid-stimulating hormone and prolactin secretion in adult premenopausal women. Fertil Steril 1995;64:698–702.10.1016/S0015-0282(16)57841-8Search in Google Scholar
24. Cedars MI, Steingold KA, Lu JH, Judd HJ, Meldrum DR. Pituitary function before, during, and after chronic gonadotropin-releasing hormone agonist therapy. Fertil Steril 1992;58:1104–7.10.1016/S0015-0282(16)55551-4Search in Google Scholar
25. Gönç N, Yordam N. Thyroid disease of children and adolescent. In Endocrinology Publications of Pediatric Endocrinology and Oxology Association, Ankara, 2003;261–360.Search in Google Scholar
26. Lisbôa PC, Curty FH, Moreira RM, Pazos-Moura CC. Effects of estradiol benzoate on 5’-iodothyronine deiodinase activities in female rat anterior pituitary gland, liver and thyroid gland. Braz J Med Biol Res 1997;30:1479–84.10.1590/S0100-879X1997001200016Search in Google Scholar
27. Lisbôa PC, Curty FH, Moreira RM, Oliveira KJ, Pazos-Moura CC. Sex steroids modulate rat anterior pituitary and liver iodothyronine deiodinase activities. Horm Metab Res 2001;33:532–5.10.1055/s-2001-17211Search in Google Scholar
28. Kanety H, Karasik A, Pariente C, Kauschansky A. Insulin-like growth factor-I and IGF binding protein-3 remain high after GnRH analogue therapy in girls with central precocious puberty. Clin Endocrinol (Oxf) 1996;45:7–12.10.1111/j.1365-2265.1996.tb02053.xSearch in Google Scholar
29. Belgorosky A, Rivarola MA. Irreversible increase of serum IGF-1 and IGFBP-3 levels in GnRH-dependent precocious puberty of different etiologies: implications for the onset of puberty. Horm Res 1998;49:226–32.10.1159/000023176Search in Google Scholar
30. Juul A, Flyvbjerg A, Frystyk J, Müller J, Skakkebaek NE. Serum concentrations of free and total insulin-like growth factor-I, IGF binding proteins -1 and -3 and IGFBP-3 protease activity in boys with normal or precocious puberty. Clin Endocrinol (Oxf) 1996;44:515–23.10.1046/j.1365-2265.1996.711531.xSearch in Google Scholar PubMed
31. Weise M, Flor A, Barnes KM, Cutler GB Jr, Baron J. Determinants of growth during gonadotropin-releasing hormone analog therapy for precocious puberty. J Clin Endocrinol Metab 2004;89:103–7.10.1210/jc.2002-021999Search in Google Scholar PubMed
32. Juul A, Scheike T, Nielsen CT, Krabbe S, Müller J, et al. Serum insulin-like growth factor I (IGF-I) and IGF-binding protein 3 levels are increased in central precocious puberty: effects of two different treatment regimens with gonadotropin-releasing hormone agonists, without or in combination with an antiandrogen (cyproterone acetate). Endocrinol Metab 1995;80:3059–67.Search in Google Scholar
33. Cohen P, Rosenfeld RG. Growth regulation. In: Griffin JE, Ojeda SR, editors. Textbook of endocrine physiology, 4th ed. Oxford: Oxford University Press, 2000;286–302.Search in Google Scholar
34. Wilson ME. Regulation of the growth hormone-insulin-like growth factor I axis in developing and adult monkeys is affected by estradiol replacement and supplementation with insulin-like growth factor I. J Clin Endocrinol Metab 1998;83:2018–28.Search in Google Scholar
©2015 by De Gruyter
Articles in the same Issue
- Frontmatter
- Highlight: Growth hormone
- Growth hormone and growth hormone deficiency – still a lot to learn
- Dynamic changes in the hypothalamic- pituitary-adrenal axis during growth hormone therapy in children with growth hormone deficiency: a multicenter retrospective study
- Pituitary gland size is a useful marker in diagnosing isolated growth hormone deficiency in short children
- Carotid intima-media thickness in children treated with growth hormone
- The c.301_302delAG PROP1 gene mutation in Romanian patients with multiple pituitary hormone deficiency
- Growth impairment and growth hormone-IGF-1 axis in infantile anorexia nervosa
- Growth hormone deficiency in a patient with mitochondrial disease
- Perrault syndrome with growth hormone deficiency: a rare autosomal recessive disorder
- Review articles
- Phosphate homeostasis and genetic mutations of familial hypophosphatemic rickets
- Gonadal malignancy risk and prophylactic gonadectomy in disorders of sexual development
- Original articles
- Carotid intimal medial thickness and its relation to endothelial dysfunction and echocardiographic changes in adolescents with type 1 diabetes
- Insulin dynamics and biochemical markers for predicting impaired glucose tolerance in obese Thai youth
- Effects of adolescence-onset hypogonadism on metabolism, bone mineral density and quality of life in adulthood
- Spectrum of clinical presentations and endocrinological findings of patients with septo-optic dysplasia: a retrospective study
- Role of circulating adipocytokines vaspin, apelin, and visfatin in the loss of appetite in underweight children: a pilot trial
- Protein-induced hyperinsulinaemic hypoglycaemia due to a homozygous HADH mutation in three siblings of a Saudi family
- Waist-to-height ratio as a screening measure for identifying adolescents with hypertriglyceridemic waist phenotype
- Assessment and relation of total and regional fat mass with bone mineral content among Indian urban adolescents
- Evaluation of the relationship between serum adropin levels and blood pressure in obese children
- Swallowed glucocorticoid therapy for eosinophilic esophagitis in children does not suppress adrenal function
- Response of vitamin D binding protein and free vitamin D concentrations to vitamin D supplementation in hospitalized premature infants
- Can school health check-ups serve as screening tool for growth anomalies and obesity in children?
- The spectrum of 46XY disorders of sex development in a University centre in Saudi Arabia
- Clinical and molecular characterization of five Spanish kindreds with X-linked adrenal hypoplasia congenita: atypical findings and a novel mutation in NR0B1
- Clinical characteristics of children referred for signs of early puberty before age 3
- Effects of GnRH analogue treatment on anterior pituitary hormones in children with central precocious puberty
- Anti-Müllerian hormone in children: a ten-year prospective longitudinal study (EarlyBird 39)
- Patient reports
- A rare cause of fatal pulmonary alveolar proteinosis: Niemann-Pick disease type C2 and a novel mutation
- Migratory polyarthritis as an adverse effect of thiamazole use in a 13-year-old girl with Graves’ disease
- Dyshormonogenesis seems to be more frequent in a group of Cameroonian children with congenital hypothyroidism
- Primary systemic carnitine deficiency: a Turkish case with a novel homozygous SLC22A5 mutation and 14 years follow-up
- Cerebral infarction and femoral venous thrombosis detected in a patient with diabetic ketoacidosis and heterozygous factor V Leiden G1691A and PAI-1 4G/5G mutations
- Combined adrenal failure and testicular adrenal rest tumor in a patient with nicotinamide nucleotide transhydrogenase deficiency
- Short communication
- Tamoxifen-associated hirsutism: an unusual side effect in a 5-year-old girl with McCune-Albright syndrome
- Letters to the Editor
- Psychiatric disorders are associated with increased risk for developing hyponatraemia in children
- Rett syndrome and precocious puberty association
Articles in the same Issue
- Frontmatter
- Highlight: Growth hormone
- Growth hormone and growth hormone deficiency – still a lot to learn
- Dynamic changes in the hypothalamic- pituitary-adrenal axis during growth hormone therapy in children with growth hormone deficiency: a multicenter retrospective study
- Pituitary gland size is a useful marker in diagnosing isolated growth hormone deficiency in short children
- Carotid intima-media thickness in children treated with growth hormone
- The c.301_302delAG PROP1 gene mutation in Romanian patients with multiple pituitary hormone deficiency
- Growth impairment and growth hormone-IGF-1 axis in infantile anorexia nervosa
- Growth hormone deficiency in a patient with mitochondrial disease
- Perrault syndrome with growth hormone deficiency: a rare autosomal recessive disorder
- Review articles
- Phosphate homeostasis and genetic mutations of familial hypophosphatemic rickets
- Gonadal malignancy risk and prophylactic gonadectomy in disorders of sexual development
- Original articles
- Carotid intimal medial thickness and its relation to endothelial dysfunction and echocardiographic changes in adolescents with type 1 diabetes
- Insulin dynamics and biochemical markers for predicting impaired glucose tolerance in obese Thai youth
- Effects of adolescence-onset hypogonadism on metabolism, bone mineral density and quality of life in adulthood
- Spectrum of clinical presentations and endocrinological findings of patients with septo-optic dysplasia: a retrospective study
- Role of circulating adipocytokines vaspin, apelin, and visfatin in the loss of appetite in underweight children: a pilot trial
- Protein-induced hyperinsulinaemic hypoglycaemia due to a homozygous HADH mutation in three siblings of a Saudi family
- Waist-to-height ratio as a screening measure for identifying adolescents with hypertriglyceridemic waist phenotype
- Assessment and relation of total and regional fat mass with bone mineral content among Indian urban adolescents
- Evaluation of the relationship between serum adropin levels and blood pressure in obese children
- Swallowed glucocorticoid therapy for eosinophilic esophagitis in children does not suppress adrenal function
- Response of vitamin D binding protein and free vitamin D concentrations to vitamin D supplementation in hospitalized premature infants
- Can school health check-ups serve as screening tool for growth anomalies and obesity in children?
- The spectrum of 46XY disorders of sex development in a University centre in Saudi Arabia
- Clinical and molecular characterization of five Spanish kindreds with X-linked adrenal hypoplasia congenita: atypical findings and a novel mutation in NR0B1
- Clinical characteristics of children referred for signs of early puberty before age 3
- Effects of GnRH analogue treatment on anterior pituitary hormones in children with central precocious puberty
- Anti-Müllerian hormone in children: a ten-year prospective longitudinal study (EarlyBird 39)
- Patient reports
- A rare cause of fatal pulmonary alveolar proteinosis: Niemann-Pick disease type C2 and a novel mutation
- Migratory polyarthritis as an adverse effect of thiamazole use in a 13-year-old girl with Graves’ disease
- Dyshormonogenesis seems to be more frequent in a group of Cameroonian children with congenital hypothyroidism
- Primary systemic carnitine deficiency: a Turkish case with a novel homozygous SLC22A5 mutation and 14 years follow-up
- Cerebral infarction and femoral venous thrombosis detected in a patient with diabetic ketoacidosis and heterozygous factor V Leiden G1691A and PAI-1 4G/5G mutations
- Combined adrenal failure and testicular adrenal rest tumor in a patient with nicotinamide nucleotide transhydrogenase deficiency
- Short communication
- Tamoxifen-associated hirsutism: an unusual side effect in a 5-year-old girl with McCune-Albright syndrome
- Letters to the Editor
- Psychiatric disorders are associated with increased risk for developing hyponatraemia in children
- Rett syndrome and precocious puberty association