Gonadotropin-releasing hormone stimulation test and diagnostic cutoff in precocious puberty: a mini review
Rahim Siti Nadirah Ab, Omar Julia, Ismail Tuan Salwani Tuan,
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( Rahim Siti Nadirah Ab )
National Defence University of Malaysia Faculty of Medicine and Defence Health
( Omar Julia )
University Sains Malaysia Chemical Pathology Laboratory
( Ismail Tuan Salwani Tuan )
University Sains Malaysia Department of Chemical Pathology
Abstract
The gonadotropin-releasing hormone (GnRH) stimulation test is a valuable tool in diagnosing and differentiating causes of early pubertal occurrences. Utility of the test can be limited in some instances, however, including the early phases of pubertal hypothalamic-pituitary-gonadal axis activation, in girls showing commonly overlapping pictures, and in obese children due to excess circulating estrogen that suppresses luteinizing hormone (LH). A lack of consistent baseline and stimulated gonadotropin cutoffs observed in different studies also contributes to limitations in testing. Nevertheless, early detection of true pathological causes for pubertal disorders is needed to allow prompt treatment and better prognosis. While basal LH can be beneficial as a good screening tool for detecting pubertal disorder, it does not preclude the need for GnRH testing. The aim of this review was to highlight the role of GnRH stimulation tests and varying testing cutoffs in diagnosis of precocious puberty and its classification.
키워드
Gonadotropin-releasing hormone; Precocious puberty; GnRH analogues; Premature thelarche
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