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  • Title: [Clinical application of simplified gonadotropin releasing hormone stimulating test in management of female isosexual precocious puberty].
    Author: Zhang YW, Ma LK, Zhou J, Zhang DY.
    Journal: Zhonghua Fu Chan Ke Za Zhi; 2004 Jun; 39(6):378-81. PubMed ID: 15312320.
    Abstract:
    OBJECTIVE: To explore the clinical application of simplified gonadotropin releasing hormone (GnRH) test in the management of female isosexual precocious puberty (IPP). METHODS: Simplified GnRH stimulating test was performed in 42 girls with IPP. Thirty-eight of them were followed-up for a mean of 26 (3 - 78) months. RESULTS: Fourteen cases showed luteinizing hormone (LH)-predominant response after GnRH stimulation, 13 showed follicle stimulating hormone (FSH)-predominant response and 15 showed no response. In the LH-predominant group, one had hypothalamic harmatoma, the other 13 were idiopathic type. Ten of them had acceleration of growth and bone prematurity. There were 8 peripheral IPP in the no response group, i.e. ovarian granulose-theca tumor 1, autonomous ovarian follicular cysts 2, McCune-Albright syndrome 2, and exogenous IPP 3. Among them, 1/2 had growth acceleration and 3/4 had bone prematurity. The remaining 7 of the no-response group and 13 with FSH-predominant response had no known etiology and were considered as transient IPP or premature thelarche based on no progression of pubertal development during follow-up. One fourth of them also showed acceleration of growth and bone prematurity. CONCLUSION: Simplified GnRH test is helpful to objectively evaluate activation of the hypothalamic-pituitary-ovary axis, and is more reliable than those clinical features in differential etiological diagnosis of female IPP.
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