TEXTBOOK PEDIATRIC GYNECOLOGY - 2013

Chapter 4. EXAMINATION METHODS IN PEDIATRIC GYNECOLOGY

DIAGNOSTIC HORMONAL TESTS IN PEDIATRIC GYNECOLOGY

The gonadotropin-releasing hormone (GnRH) test is used to evaluate the functional status of the hypothalamic-pituitary axis in children with DISORDERS OF SEXUAL development. The test assesses the ability of pituitary gonadotrophs to respond to GnRH stimulation with an increased Blood level (or urinary excretion) of LH and FSH.

Procedure: 2.5 mcg/kg of the agent (luliberin, relefact, cryptocur) is administered intravenously, and blood levels of LH and FSH are measured immediately and at 30, 60, 90, and 120 minutes.

The increase in both hormone levels in response to stimulation correlates with bone age. From the onset of Puberty, the sensitivity of the Pituitary Gland to the stimulatory effect of GnRH changes: the maximum increase is observed at 11-15 years of age, while the minimum is seen in young children and adults. In general, the rise in LH levels is greater than that of FSH.

This test is useful for the Cytology/practical/136.html">Differential Diagnosis OF secondary hypogonadism versus constitutional delay of puberty, complete versus incomplete forms of precocious puberty (PP) in girls, and true PP versus symptomatic forms of PP.

In true PP in girls, an exceptionally high sensitivity of pituitary gonadotrophs to the stimulatory effect of luliberin is detected. The increase in LH levels exceeds pubertal values, whereas the FSH level is significantly lower.

Assessment of Growth Hormone (GH) secretion is essential in children with short stature, idiopathic Hypopituitarism, acromegaly, dwarfism, and tumors.

The child's thyroid status must be evaluated prior to the test!

Screening tests for GH deficiency: measuring the hormone in blood samples obtained 60-120 minutes after falling asleep or following Physical Exercise in children provides a reliable assessment of GH secretion. If screening tests fail to show a significant rise in hormone levels, further investigation of GH secretion using synthetic GHRH is required.



Last update: 08/08/2026

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