Hormonal Pattern of Plasma LH, FSH and Prolactin in Girls with Premature Thelarche and Advanced Bone Age: A Synonym for Precocious Puberty

Publisher Website
Google Scholar
Abstract
Three girls with premature thelarche and advanced bone age of at least 2 yr were investigated before and during cyproterone-acetate [CA] treatment. To confirm the diagnosis of precocious puberty the hormonal pattern of LH [luteinizing hormone], FSH [follicle stimulating hormone] and prolactin [PRL] were determined at 1800, 2200, 0200 and 0800 h, as well as the responsiveness 30 min after a LRH[luteinizing releasing hormone]/TRH[thyrotropin releasing hormone] stimulation. Basal plasma FSH levels were elevated in comparison to those found in control females with a comparable degree of sexual maturation. In comparison, an increased gonadotropin release at sleep was found in all 3 girls, whereas the nocturnal increase of plasma PRL was nearly similar to control females. An excessive gonadotropin response to LRH stimulation was demonstrable in all 3 girls. Plasma PRL response to TRH was comparable to control females. CA was administered in a dosage of 150 mg/m2. During CA treatment, basal plasma LH levels were depressed to subnormal values without any signs of a nocturnal hormone rhythm. Basal plasma FSH levels were also reduced although a nocturnal increase was still existent being lower than in control females. Basal plasma PRL levels increased 3- to 5-fold without increasing hormone values at night. The response of elevated basal PRL levels to TRH stimulation was minimal. The hormonal patterns in girls with premature thelarche and advanced bone age are comparable to those found in girls with precocious puberty. Therefore, these patients should also be classified as idiopathic precocious puberty. CA apparently operates at hypothalamic and/or pituitary levels in stimulating PRL release.