Sterile Abscess Formation Associated with Two Different Forms of Gonadotropin-Releasing Hormone Agonist in Central Precocious Puberty

Abstract

Long-acting formulations of gonadotropin-releasing hormone (GnRH) agonists are indicated for treating central precocious puberty. Leuprolide acetate and triptorelin acetate are widely used in Korea. Local reactions related to GnRH agonists, including erythematous macules, granulomas, subcutaneous nodules, and sterile abscesses, are the most side effects and sterile abscesses occur in less than 2-3% of treated patients. We report on two patients who had been injected with leuprolide acetate for the treatment of central precocious puberty and who subsequently presented with a sterile abscess at the injection sites. After the patients were switched to triptorelin acetate, one patient had another subcutaneous abscess at the injection site, and the other patient had no further problems. There are many theories as to the cause of these local reactions, but the mechanism has still not been elucidated. Further studies are required to identify the mechanism and the relationship between treatment effect and local reaction.