Sterile abscess formation with two different GnRH analogues: Three case reports

Abstract

Gonadotropin-releasing hormone analogues (GnRHa) have been used safely for many years in the treatment of precocious puberty. Although rare, pain, swelling, and erythema at the injection site are known local side effects in patients receiving GnRHa treatment and are temporary. Sterile abscess development is also one of the rare local side effects. Here, we present three cases of treatment failure due to the development of sterile abscesses after GnRHa therapy. Sterile abscesses developed in three girls who were followed up with a diagnosis of precocious/progressive puberty respectively in 4., 12. and 5. doses of GnRHa treatment. In the first case, a sterile abscess recurred despite the therapy being switched to another preparation. We had to follow up without treatment in three of our cases. Although sterile abscess is a rare side effect, it is essential as it causes patients to be left untreated. In these cases, the drug’s active substance accumulates in the localization at the sterile abscess and cannot be absorbed, so it cannot enter the systemic circulation. Therefore, puberty cannot be suppressed. Also, a remaining scar is annoying for patients and their families.