A Cost-Benefit of GnRH Stimulation Test in Diagnosis of Central Precocious Puberty ( CPP)

SUTTIPONG WACHARASINDHU, M.D., M.R.C.P.(UK)*, SUPHAB AROONPARKMONGKOL, B.Sc.*, SUMARLEE SRIVUTHANA, M.D.*, VORASUK SHOTELERSUK, M.D.*

Affiliation : *Endocrine Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand.

AbstractThe GnRH stimulation test is the gold standard to diagnose central precocious puberty (CPP). Conventionally, we need at least 2 hours to finish the test which seems to be costly and time consuming. In this study, we described the pattern of LH and FSH levels during the GnRH test in 27 girls who presented with various degrees of precocious puberty. We found that the blood samples at 90 and 120 min after GnRH were not necessary. To save the cost of diagnosis, the basal LHIFSH ratio> 0.2, the 30 min LHIFSH ratio after GnRH > 0.9 and the peak LH/FSH ratio > 1.0 can be used to diagnose CPP with positive predictive values (PPV) of 87.3, 89.4 and 93.8 per cent respectively.

Keywords : Precocious Puberty

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