{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T08:30:24Z","timestamp":1774686624189,"version":"3.50.1"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,3,28]],"date-time":"2017-03-28T00:00:00Z","timestamp":1490659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Differentiation between constitutional delay in puberty (<jats:styled-content style=\"fixed-case\">CDP<\/jats:styled-content>) and isolated hypogonadotropic hypogonadism (<jats:styled-content style=\"fixed-case\">IHH<\/jats:styled-content>) during adolescence is a great clinical challenge, and the available diagnostic tests are of limited value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the effect of withdrawal of short\u2010term, low\u2010dose testosterone therapy (testosterone priming) on the discriminatory power of dynamic tests for hypothalamo\u2013pituitary\u2013testicular axis to differentiate <jats:styled-content style=\"fixed-case\">CDP<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">IHH<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A prospective study (<jats:italic>n<\/jats:italic> = 30) consisting of 20 boys with delayed puberty (group A) and 10 patients with <jats:styled-content style=\"fixed-case\">IHH<\/jats:styled-content> (group B).<\/jats:p><\/jats:sec><jats:sec><jats:title>Intervention<\/jats:title><jats:p>Patients in groups A and B underwent Triptorelin and <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content> stimulation tests, prior to and 2 months after withdrawal of \u2018testosterone priming\u2019 (100 mg intramuscularly 4 weekly for 3 months) and were followed up until the onset of puberty or 18 years of age, whichever was earlier.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, Triptorelin\u2010stimulated 4 h <jats:styled-content style=\"fixed-case\">LH<\/jats:styled-content>, with a cut\u2010off of 2\u00b78 IU\/l, and <jats:styled-content style=\"fixed-case\">hCG<\/jats:styled-content>\u2010stimulated day 7 testosterone with a cut\u2010off of 3\u00b78 nmol\/l had sensitivities of 80% each, and specificities of 93% and 87%, respectively, to diagnose <jats:styled-content style=\"fixed-case\">CDP<\/jats:styled-content>. After withdrawal of testosterone, a 4 h <jats:styled-content style=\"fixed-case\">LH<\/jats:styled-content> cut\u2010off of 14\u00b77 IU\/l and day 7 testosterone cut\u2010off of 10\u00b73 nmol\/l had sensitivities of 93% and 88% respectively, and specificity and positive predictive value of 100% each. A basal inhibin B &gt; 94\u00b77 ng\/l was discriminatory for diagnosing <jats:styled-content style=\"fixed-case\">CDP<\/jats:styled-content> after withdrawal of testosterone priming.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Inhibin B levels or 4 h <jats:styled-content style=\"fixed-case\">LH<\/jats:styled-content> after Triptorelin stimulation are the best discriminatory tests to differentiate <jats:styled-content style=\"fixed-case\">CDP<\/jats:styled-content> from <jats:styled-content style=\"fixed-case\">IHH<\/jats:styled-content>, when performed after withdrawal of \u2018testosterone priming\u2019.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13321","type":"journal-article","created":{"date-parts":[[2017,3,6]],"date-time":"2017-03-06T01:56:39Z","timestamp":1488765399000},"page":"717-724","source":"Crossref","is-referenced-by-count":15,"title":["Diagnostic utility of testosterone priming prior to dynamic tests to differentiate constitutional delay 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