Response of South Indian girls with central precocious puberty to gonadotrophin analogue (GnRHa) therapy – a single center experience

Aim of the study
To describe the clinical, auxological, biochemical and radiological response to GnRH analogue in female children with central precocious puberty (CPP).

Material and methods
The data on 22 female children presenting with the larche < 8 years, pubarche < 8 years or menarche < 9 years diagnosed as CPP was collected from the records over a four year period. Assessment included growth parameters, Tanners staging; bone age (BA) by Greulich and Pyle method, ultrasonography of abdomen to assess uterine length and ovarian size and z score derived; biochemical evaluation included serum luteinising hormone (LH), follicle stimulating hormone (FSH) and estradiol (E2); and MRI brain. The children were initiated on injection Leupride 0.9 mg/kg 3 monthly (body weight < 30 kg received 11.25 mg and > 30 kg received 22.5 mg). The predicted adult height (PAH) was calculated with Bayley Pinneau method.

Results
Treatment was started at the mean chronological age (CA) of 6.09 ±2.1 years and continued till 8.3 ±2.4 years. MRI brain was abnormal in 4 children. Duration of treatment was 2.1 ±0.4 years. The height z scores reduced from 0.5 ±2.4 to 0.18 ±2.4 (p < 0.05). A significant reduction in tanner’s stage, uterine size and ovarian volume was observed in the study period. BA/CA ratio reduced from 1.27 ±0.4 to 1.07 ±0.3. PAH z score improved from 1.47 ±1.6 to 0.2 ±2.3 (p < 0.05).

Conclusions
We observed a good clinical and radiological response to GnRHa therapy in girls with CPP and a significant improvement in PAH. Long term follow up is needed to assess the attainment of final height