Five children (2 M, 3 F) aged 3.5-9.5 yrs, with central precocious puberty and 1 boy (12 yrs old)with corpus callosum agenesis and sexual aggressive behaviour, have been treated with LH-RH Analogue (Buserelin): a)First 15 days:30±10% mcg/Kg/die subcutaneously; b)Later:1200 mcg/die intranasal, via nebulizer in 3 doses. Each child was assessed for a complete hormonal picture, particularly: a)LHRH test and sexual steroids(Ria method);b)Biological and radioimmunological assay for LH(-30′, -15′, 0)and the mean of the biological/immunoreactive LH ratio(B/I;prepubertal values <0.6) (Fraioli et al.J.Endocrinol.Invest.8:513, 1985). Our results, both clinical and biochemical, returned to normalprepubertal condition at 1 month until the 3rd mo. After this time, they showed an escape of B/I ratio, raising at 2.8(6 mo);2.16(4 mo); 3.1 (4 mo);2.7(12 mo) in spite of persisting normalization of clinical findings and sexual steroid levels. These results can be attributed to an inadequate or discontinuous absorption during the intranasal administration or to a hypothetical change of LH native molecule, occurring during long-term treatment. The elevation of B/I seems to represent an early useful monitor for a new assessment of dosage or route of administration.
Read full abstract