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

Meghana Selvaraj; Hemchand Krishna Prasad; Bharath Ramji; Anand Thiagarajan; Kannan Narayanasamy; Nedunchelian Krishnamoorthy

doi:10.5114/pedm.2021.109125

eISSN: 2083-8441
ISSN: 2081-237X

Pediatric Endocrinology Diabetes and Metabolism

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abstract:

Original paper

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

Meghana Selvaraj

¹

,

Hemchand Krishna Prasad

²

,

Bharath Ramji

^{3, 4}

,

Anand Thiagarajan

⁵

,

Kannan Narayanasamy

¹

,

Nedunchelian Krishnamoorthy

¹

Department of Pediatrics, Mehta Multispeciality Hospitals India Pvt Ltd, India
Department of Pediatric Endocrinology, Mehta Multispeciality Hospitals India Pvt Ltd, India
Department of Endocrinology, Mehta Multispeciality Hospitals India Pvt Ltd, India
Consultant Endocrinologist, Arka Centre for Hormonal Health, India
Department of Radiology, Mehta Multispeciality Hospitals India Pvt Ltd, India

Pediatr Endocrinol Diabetes Metab 2021; 27 (4): 253–257

DOI: https://doi.org/10.5114/pedm.2021.109125

Online publish date: 2021/12/30

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AMA

Selvaraj M, Krishna Prasad H, Ramji B, Thiagarajan A, Narayanasamy K, Krishnamoorthy N. Response of South Indian girls with central precocious puberty 
to gonadotrophin analogue (GnRHa) therapy – a single center experience. Pediatric Endocrinology Diabetes and Metabolism. 2021;27(4):253-257. doi:10.5114/pedm.2021.109125.

APA

Selvaraj, M., Krishna Prasad, H., Ramji, B., Thiagarajan, A., Narayanasamy, K.,  & Krishnamoorthy, N. (2021). Response of South Indian girls with central precocious puberty 
to gonadotrophin analogue (GnRHa) therapy – a single center experience. Pediatric Endocrinology Diabetes and Metabolism, 27(4), 253-257. https://doi.org/10.5114/pedm.2021.109125

Chicago

Selvaraj, Meghana, Hemchand Krishna Prasad, Bharath Ramji, Anand Thiagarajan, Kannan Narayanasamy,  and Nedunchelian Krishnamoorthy. 2021. "Response of South Indian girls with central precocious puberty 
to gonadotrophin analogue (GnRHa) therapy – a single center experience". Pediatric Endocrinology Diabetes and Metabolism 27 (4): 253-257. doi:10.5114/pedm.2021.109125.

Harvard

Selvaraj, M., Krishna Prasad, H., Ramji, B., Thiagarajan, A., Narayanasamy, K.,  and Krishnamoorthy, N. (2021). Response of South Indian girls with central precocious puberty 
to gonadotrophin analogue (GnRHa) therapy – a single center experience. Pediatric Endocrinology Diabetes and Metabolism, 27(4), pp.253-257. https://doi.org/10.5114/pedm.2021.109125

MLA

Selvaraj, Meghana et al. "Response of South Indian girls with central precocious puberty 
to gonadotrophin analogue (GnRHa) therapy – a single center experience." Pediatric Endocrinology Diabetes and Metabolism, vol. 27, no. 4, 2021, pp. 253-257. doi:10.5114/pedm.2021.109125.

Vancouver

Selvaraj M, Krishna Prasad H, Ramji B, Thiagarajan A, Narayanasamy K, Krishnamoorthy N. Response of South Indian girls with central precocious puberty 
to gonadotrophin analogue (GnRHa) therapy – a single center experience. Pediatric Endocrinology Diabetes and Metabolism. 2021;27(4):253-257. doi:10.5114/pedm.2021.109125.

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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

keywords:

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

Meghana Selvaraj 1 , Hemchand Krishna Prasad 2 , Bharath Ramji 3, 4 , Anand Thiagarajan 5 , Kannan Narayanasamy 1 , Nedunchelian Krishnamoorthy 1

bone age, precocious puberty, gonadotrophin analogue therapy, predicted adult height

Meghana Selvaraj

¹

,

Hemchand Krishna Prasad

²

,

Bharath Ramji

^{3, 4}

,

Anand Thiagarajan

⁵

,

Kannan Narayanasamy

¹

,

Nedunchelian Krishnamoorthy

¹