Introduction: GnRH analogues common used in precocious puberty are highly effective agents. The drug dose and injection frequency should be designed for each case. However these agents are common well tolerated, some rare adverse effects may be occur. We present a case of frequent leuprolid acetate injections-related sterile abscess.
Case: The case was 16-month-old boy. He had rapid growth, big penis, and excessive pubic hair. These symptoms have appeared since last year. Both height and weight were over 97th percentiles. His stretched penil length was 7 cm and bilateral testicular volume were 6 ml. Bone age was 3 years old. Hormone tests: basal FSH: 11.2 mIU/ml, LH: 6.7 mUI/ml, and testesterone: 43 pg/ml. Pituitary MR had no abnormal findings. We diagnosed central precocious puberty. Then, we started leuprolid acetate (Lucrin 3.75®) injections once every 4 months. But we didnt observe response to treatment. We had to give injections respectively once every 3 weeks and once every 2 weeks. We managed to suppress gonadotropin secretion. After four weeks, sterile abscesses appeared in his arm and leg. Abscesses were drained by surgeons. We replaced leuprolid acetate to triptorelin acetate (Decapeptyl 3.75®). We gave injections once in 10 days.
Conclusion: During the precocious treatment, the rare adverse effects like sterile abscess may occur and they shouldnt be ignored by clinicians. Severe precocious puberty case can be treated with more frequent injections and higher doses.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology