{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T09:05:19Z","timestamp":1771232719871,"version":"3.50.1"},"reference-count":14,"publisher":"Walter de Gruyter GmbH","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,8,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2019-0414_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Basal (unstimulated) LH levels and leuprolide stimulation tests are used to define pubertal status of children presenting with signs of early puberty. The primary aims of this study were to (i)\u00a0confirm utility of detectable basal LH levels in precluding the need for leuprolide stimulation testing, and, (ii) determine whether duration of testing could be abbreviated from usual 3\u00a0h test without compromising sensitivity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2019-0414_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We reviewed morning basal and leuprolide-stimulated LH levels in 105 children, aged 1\u20139 years (mean 6.9 years, SD 1.8) who were seen for concerns of precocious puberty and received a leuprolide stimulation test between June 2006 and March 2017.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2019-0414_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A pubertal basal LH level had high specificity and poor sensitivity for the following outcome measures: (1) peak stimulated LH\u22655\u00a0mIU\/mL (2) treatment with GnRHa; and (3) a composite outcome of (1) and\/or (2). Following leuprolide stimulation, LH response was highest at 180\u00a0min in most children (n=78, 74.3%). Using a single cutoff of LH\u22655\u00a0mIU\/mL at any timepoint, 25% of children would have been misdiagnosed with an abbreviated 60\u00a0min test. A single sample at 180\u00a0min would have correctly identified 97% of patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2019-0414_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A pubertal basal LH level is sufficient to distinguish children with precocious puberty without stimulation testing. However, prepubertal basal LH had relatively poor negative predictive value to refute CPP, necessitating clinical follow-up and\/or a leuprolide stimulation test. For a cutoff of LH\u22655\u00a0mIU\/mL at any timepoint, test duration of 180\u00a0min maximizes sensitivity.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2019-0414","type":"journal-article","created":{"date-parts":[[2020,7,22]],"date-time":"2020-07-22T13:31:31Z","timestamp":1595424691000},"page":"1073-1081","source":"Crossref","is-referenced-by-count":7,"title":["Utility and duration of leuprolide stimulation testing in children"],"prefix":"10.1515","volume":"33","author":[{"given":"Jasreena K.","family":"Nijjar","sequence":"first","affiliation":[{"name":"Pediatric Endocrine Unit , Massachusetts General Hospital for Children and Harvard Medical School , Boston , MA , USA"},{"name":"Center for Endocrinology, Diabetes, and Metabolism , Children\u2019s Hospital of Los Angeles , Los Angeles , CA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian J.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Neuroendocrine Unit and Metabolism Unit , Massachusetts General Hospital and Harvard Medical School , Boston , MA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madhusmita","family":"Misra","sequence":"additional","affiliation":[{"name":"Pediatric Endocrine Unit , Massachusetts General Hospital for Children and Harvard Medical School , Boston , MA , USA"},{"name":"Neuroendocrine Unit and Metabolism Unit , Massachusetts General Hospital and Harvard Medical School , Boston , MA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takara L.","family":"Stanley","sequence":"additional","affiliation":[{"name":"Pediatric Endocrine Unit , Massachusetts General Hospital for Children and Harvard Medical School , Boston , MA , USA"},{"name":"Neuroendocrine Unit and Metabolism Unit , Massachusetts General Hospital and Harvard Medical School , Boston , MA , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2020,7,20]]},"reference":[{"key":"2021082202005778544_j_jpem-2019-0414_ref_001","doi-asserted-by":"crossref","unstructured":"Harrington, J, Palmert, MR, Hamilton, J. Use of local data to enhance uptake of published recommendations: an example from the diagnostic evaluation of precocious puberty. Arch Dis Child 2014 Jan;99:15\u201320. https:\/\/doi.org\/10.1136\/archdischild-2013-304414.","DOI":"10.1136\/archdischild-2013-304414"},{"key":"2021082202005778544_j_jpem-2019-0414_ref_002","doi-asserted-by":"crossref","unstructured":"Neely, EK, Wilson, DM, Lee, PA, Stene, M, Hintz, RL. Spontaneous serum gonadotropin concentrations in the evaluation of precocious puberty. J Pediatr 1995 Jul;127:47\u201352. https:\/\/doi.org\/10.1016\/s0022-3476(95)70255-5.","DOI":"10.1016\/S0022-3476(95)70255-5"},{"key":"2021082202005778544_j_jpem-2019-0414_ref_003","doi-asserted-by":"crossref","unstructured":"Houk, CP, Kunselman, AR, Lee, PA. Adequacy of a single unstimulated luteinizing hormone level to diagnose central precocious puberty in girls. Pediatrics 2009 Jun;123:e1059\u201363. https:\/\/doi.org\/10.1542\/peds.2008-1180.","DOI":"10.1542\/peds.2008-1180"},{"key":"2021082202005778544_j_jpem-2019-0414_ref_004","doi-asserted-by":"crossref","unstructured":"Houk, CP, Kunselman, AR, Lee, PA. The diagnostic value of a brief GnRH analogue stimulation test in girls with central precocious puberty: a single 30-minute post-stimulation LH sample is adequate. J Pediatr Endocrinol Metab 2008 Dec;21:1113\u20138. https:\/\/doi.org\/10.1515\/jpem.2008.21.12.1113.","DOI":"10.1515\/JPEM.2008.21.12.1113"},{"key":"2021082202005778544_j_jpem-2019-0414_ref_005","doi-asserted-by":"crossref","unstructured":"Chi, CH, Durham, E, Neely, EK. Pharmacodynamics of aqueous leuprolide acetate stimulation testing in girls: correlation between clinical diagnosis and time of peak luteinizing hormone level. J Pediatr 2012 Oct;161:757\u20139e1. https:\/\/doi.org\/10.1016\/j.jpeds.2012.06.015.","DOI":"10.1016\/j.jpeds.2012.06.015"},{"key":"2021082202005778544_j_jpem-2019-0414_ref_006","doi-asserted-by":"crossref","unstructured":"Bordini, B, Littlejohn, E, Rosenfield, RL. Blunted sleep-related luteinizing hormone rise in healthy premenarcheal pubertal girls with elevated body mass index. J Clin Endocrinol Metab 2009 Apr;94:1168\u201375. https:\/\/doi.org\/10.1210\/jc.2008-1655.","DOI":"10.1210\/jc.2008-1655"},{"key":"2021082202005778544_j_jpem-2019-0414_ref_007","doi-asserted-by":"crossref","unstructured":"Kandemir, N, Demirbilek, H, Ozon, ZA, Gonc, N, Alikasifoglu, A. GnRH stimulation test in precocious puberty: single sample is adequate for diagnosis and dose adjustment. J Clin Res Pediatr Endocrinol 2011;3:12\u20137. https:\/\/doi.org\/10.4274\/jcrpe.v3i1.03.","DOI":"10.4274\/jcrpe.v3i1.03"},{"key":"2021082202005778544_j_jpem-2019-0414_ref_008","doi-asserted-by":"crossref","unstructured":"Sathasivam, A, Garibaldi, L, Shapiro, S, Godbold, J, Rapaport, R. Leuprolide stimulation testing for the evaluation of early female sexual maturation. Clin Endocrinol (Oxf). 2010 Sep;73:375\u201381. https:\/\/doi.org\/10.1111\/j.1365-2265.2010.03796.x.","DOI":"10.1111\/j.1365-2265.2010.03796.x"},{"key":"2021082202005778544_j_jpem-2019-0414_ref_009","doi-asserted-by":"crossref","unstructured":"Yazdani, P, Lin, Y, Raman, V, Haymond, M. A single sample GnRHa stimulation test in the diagnosis of precocious puberty. 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