Gonadotropin Suppression for 7 Years After a Single Histrelin Implant for Precocious Puberty

Douglas Villalta; Jose B. Quintos

J Endo Soc. 2022;6(2)

Conclusion

We present a patient with continuous gonadotropin suppression for 7 years after a single histrelin implant. Gonadotropin hormone analogues are effective treatments to delay compromise in height attainment in patients with central precocious puberty. Creation of a database that tracks the insertion and removal of histrelin implants can reduce the likelihood of an implant remaining longer than clinically indicated. With this, further studies are needed to demonstrate the effectiveness of long-term suppression of gonadotropin hormones beyond what is currently being reported in the literature. Further studies are also needed to elucidate the mechanism of the prolonged gonadotropin suppression beyond 2 years.

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Abbreviations
BMI, body mass index; CPP, central precocious puberty; FSH, follicle-stimulating hormone; GnRH, gonadotropin-releasing hormone; GnRHa, gonadotropin-releasing hormone analogue; LH, luteinizing hormone.

Financial Support
None.

Data Availability
Data sharing is not applicable to this article because no data sets were generated or analyzed during the present study.

Table 1. Baseline and follow-up laboratory results, growth, pubertal progression
Chronological age	9 y 11 mo	10 y 6 mo	11 y 0 mo	11 y 4 mo	11 y 10 mo	17 y 7 mo	17 y 11 mo	18 y 2 mo
Bone age	11 y 6 mo			12 y 6 mo	13 y 0 mo	14 y 0 mo
Height, cm	141.5	146.4	147.2	149	152	167.8		170.4
Growth velocity, cm/year	10.7	11.3	2.2	4.6	6.5	2.7		5.5
Mid-parental target height	175.3
Testicular volume, mL	15	12	12		12	8 R 10 L		10 R 12 L
Estradiol, pg/mL						9.9
Testosterone, ng/dL	628	5			5	8.7	172	506
LH, mIU/mL	9.4	0.20			0.16	0.10	3.7	5.6
FSH, μIU/mL	16.3	0.10			0.16	0.34	1.8	4.3
17-OHP, ng/dL	217
DHEAS, mcg/dL	127
Prolactin, ng/mL	10
Treatment	Started Lupron 11.25 mg monthly for 4 mos	5 mos post-suppression	13-mos post-suppression			87 mos post-suppression	1-mo post-explantation	4 mos post-explantation
		1-month post-histrelin				84 mos post-histrelin

Abbreviations: 17-OHP, 17-hydroxyprogresterone; DHEAS, dehydroepiandrosterone sulfate; FSH, follicle-stimulating hormone; L, left; LH, lutenizing-hormone; mo, month; R, right; y, year;