Resumption of puberty after long term luteinizing hormone-releasing hormone agonist treatment of central precocious puberty

To determine whether puberty resumes normally after long term LHRH agonist (LHRHa) treatment, we studied 16 children with central precocious puberty treated with LHRHa (d-Trp6,Pro9,NEt-LHRH) for 1–4 yr (mean, 3.3 yr). Treatment was discontinued at a mean age of 11.6 ± 1.3 (±sd) yr. Plasma hormone levels, growth velocity, rate of bone maturation, and pubertal stage were assessed at the end of treatment and 3 and 12 months later. Basal plasma sex steroid and basal and LHRH-stimulated gonadotropin levels returned to near-pretreatment levels 3 months after discontinuation of therapy and were fully restored to pretreatment levels at 12 months. Growth velocity, which had been 7.8 cm/yr before treatment, was stable after discontinuation of treatment at approximately 2.6 cm/yr. The predicted height, which had increased during treatment (P < 0.01), remained stable at approximately 5 cm above the pretreatment predicted height. The rate of bone age advancement (Δbone age/Δchronological age) increased gradually from ...