Summary
Three girls with premature thelarche and advanced bone age of at least 2 years are
investigated before and during cyproterone-acetate treatment. To confirm the diagnosis
of precocious puberty the hormonal pattern of LH, FSH and prolactin were determined
at 1800 h, 2200 h, 0200 h and 0800 h, as well as the responsiveness 30 min after a
LRH/TRH stimulation. Basal plasma FSH levels were elevated in comparison to those
found in control females with a comparable degree of sexual maturation. In comparison,
an increased gonadotropin release at sleep was found in all three girls, whereas the
nocturnal increase of plasma prolactin was nearly similar to control females. An excessive
gonadotropin response to LRH stimulation was demonstrable in all three girls. Plasma
prolactin response to TRH was comparable to control females.
Cyproterone-acetate (CA) was administered in a dosage of 150 mg/m2. During CA treatment, basal plasma LH levels were depressed to subnormal values without
any signs of a nocturnal hormone rhythm. Basal plasma FSH levels were also reduced
although a nocturnal increase was still existent being lower than in control females.
Basal plasma prolactin levels, however, increased three- to fivefold without increasing
hormone values at night. The response of elevated basal prolactin levels to TRH stimulation
was minimal.
These results suggest that the hormonal pattern in girls with premature thelarche
and advanced bone age are comparable to those found in girls with precocious puberty.
Therefore, these patients should also be classified as “idiopathic precocious puberty”.
It may be hypothesized that CA operates at hypothalamic and/or pituitary levels in
stimulating prolactin release.
Key-Words
Premature Thelarche
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Precocious Puberty
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Cyproterone-Acetate
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Hyperprolactinaemia
