[Long-term therapy of central precocious puberty in girls with the gonadoliberin analog D-Trp-6-LHRH after prior therapy with cyproterone acetate].

A group of five girls with central precocious puberty (CPP) (four girls with idiopathic CPP and one girl with organically conditioned CPP) were treated for a mean period of 17 months (12-20 months) with an agonist of gonadoliberine (aGnRH) D-Trp-6-LHRH(Triptorelin), 60-100 micrograms/kg by the i.m. route, every four weeks. The calendar age (CA) of the girls was at the onset of aGnRH treatment 7.3 +/- 0.7 years, the bone age (BA) 9.6 +/- 1.0 years. Previously Cyproterone acetate treatment administered for an average period of 26 months (4-56 months) was gradually discontinued in the course of 12 weeks. After 12 months aGnRH treatment the growth rate slowed down from 8.1 #/- 2.1 to 6.2 +/- 1.7 cm/year (NS). The bone age increment per calendar year declined at the end of the first year of treatment from 1.7 +/- 0.8 to 0.94 +/- 0.4 (NS). Prediction of the adult height did not change in the course of one year (before aGnRH therapy 158.6 +/- 5.3 after one year's treatment 159.0 +/- 5.3 cm). In all girls premature maturing was arrested already during the original Cyproterone acetate treatment. With the exception of a single patient during aGnRH therapy progression was not recorded. In this girl with the idiopathic form of CPP the authors observed during regular Triptorelin administration, starting from the fourth month, clinical and biochemical manifestations of secondary therapeutic failure after termination of hitherto administered Cyproterone acetate treatment-"escape from treatment". Clinical and hormonal indicators improved after addition of Cyproterone acetate. This patient lacks typical symptoms suggesting McCune-Albright's syndrome.