Abnormal puberty in paediatric Cushing's disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations.

Abnormal puberty in paediatric Cushing's disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations. Research Abstract Details 

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Abnormal puberty in paediatric Cushing's disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations. Abstract Text:

C C Dupuis,H L Storr,L A Perry,J T F Ho,L Ahmed,K K Ong,D B Dunger,J P Monson,A B Grossman,G M Besser,M O Savage,

OBJECTIVE: Paediatric Cushing's disease is frequently associated with abnormal puberty. We addressed the hypothesis that prepubertal patients show excessive virilization and pubertal patients show suppression of LH and FSH secretion. DESIGN AND MEASUREMENTS: Serum androstenedione (A4), dehydroepiandrosterone sulphate (DHEAS), testosterone (T), and sex hormone binding globulin (SHBG) were determined at diagnosis and converted to standard deviation scores. LH, FSH concentrations were also determined. Severity of CD was assessed from the sleeping midnight cortisol concentration. Puberty was staged and excessive virilization defined as advance in pubic hair stage for breast stage or testicular volume (TV). PATIENTS: Twenty-seven CD patients (17 male, 10 female), median age 13.4 years (range 5.9-17.8) were studied. RESULTS: In the CD group as a whole, A4, DHEAS, T standard deviation scores (SDS) values were normal. SHBG SDS values (n = 19) were low (median -1.93, -4.32-0.86) correlating with BMI (r = -0.49). A4, DHEAS, T, SHBG, LH and FSH did not correlate with midnight cortisol, but A4 and T SDS correlated with ACTH at 09.00 h (both r = 0.51). Thirteen patients (11 male, 2 female) had excessive virilization with increased A4 (P = 0.033), DHEAS (P = 0.008), testosterone (P = 0.033) and decreased SHBG (P = 0.004) compared with subjects without excessive virilization. Pubertal boys (TV > or = 4 ml) (n = 7) and girls (breasts > or = stage 2) (n = 8) had low median LH and FSH. Boys had an LH concentration of 1.2 mU/l (0.3-3.5), FSH, 0.9 mU/l (0.2-6.4) and median T SDS, -1.95 (-3.8-4.65), while girls had an LH concentration of 1 mU/l (0.3-7.4). CONCLUSIONS: Many patients had abnormal puberty and excessive virilization associated with increased adrenal androgens and decreased SHBG. Pubertal patients had low LH and FSH suggesting impaired pituitary-gonadal axis function.

Abnormal puberty in paediatric Cushing's disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations. Publishing Authors By Initials

CC Dupuis,HL Storr,LA Perry,JT Ho,L Ahmed,KK Ong,DB Dunger,JP Monson,AB Grossman,GM Besser,MO Savage,

For similar pathological conditions, signs and symptoms: signs and symptoms: virilism research abstracts see: pathological conditions, signs and symptoms: signs and symptoms: virilism research

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Abnormal puberty in paediatric Cushing's disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Clinical endocrinology

VOLUME: 66

Page Numbers: 838-43

Journal Abbreviation: Clin. Endocrinol. (Oxf)

ISSN: 0300-0664

DAY: 15

MONTH: 04

YEAR: 2007

Abnormal puberty in paediatric Cushing's disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations. Information

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LANGUAGE: eng

NlmUniqueID: 346653

Abnormal puberty in paediatric Cushing's disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations. Keywords Mesh Terms:

KEYWORDS: Virilism

MESH TERMS: etiology

Chemical & Substance for Abstract: Abnormal puberty in paediatric Cushing's disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations. Information

Substance Name: Follicle Stimulating Hormone

Registry Number: 9002-68-0

Grant and Affiliation Information for Abnormal puberty in paediatric Cushing's disease: relationship with adrenal androgen, sex hormone binding globulin and gonadotrophin concentrations.

AFFILIATION: Department of Endocrinology, Barts and the Royal London School of Medicine and Dentistry, London, UK.

Country: England

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MEDLINETA: Clin Endocrinol (Oxf)

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