ESPE Abstracts

Purpose: Gonadotropin-releasing hormone agonists (GnRHa) are commonly used to treat children with central precocious puberty and generally well-tolerated. However, as the number of cases using increases, drug-related adverse reactions are also on the rise. This study aim ed to report the clinical experience with hypersensitivity reactions in pediatric patients receiving GnRHa at a tertiary medical center, especially the relatively rare cases of failure to suppress hypothalamic-pituitary-gonadal axis HPGA） The analysis focuses on clinical characteristics and management strategies, providing clinical guidance for scientific medication and management.

Methods: A retrospective study was performed in pediatric patients， who were treated with GnRHa at our Children's Growth and Development Center between January 1990 and July 2023，and the data were evaluated. We analyzed the clinical characteristics of patients who experienced adverse reactions and provides a preliminary assessment of the incidence rate.

Results: The number of adverse reaction was out of 20 in 9 patients (0.75%) among total of 1203 CPP and early and fast puberty children with GnRHa therapy. Anaphylaxis occurred in 5 patients (0.42%). Sterile abscesses were observed in 4 patients (0.33%). and liver function impairment in 1 patient. Notably, Case 1 was particularly unique, as the patient was allergic to multiple types of GnRHa, exhibiting a variety of symptoms, such as allergic reactions, aseptic abscesses, and a failure to suppress the HPGA, leading to treatment failure.

Conclusion: In our study, 0.74% of the patients experienced adverse reactions. Local skin reactions were the most common, but anaphylaxis was also not uncommon, leading to failure in suppressing the HPGA possibly. Clinicians should be aware of these potential adverse effects associated with GnRHa therapy and their management strategies, and avoid treatment delays or unnecessary interventions.

Key words: Gonadotropin-releasing hormone analogue，Central precocious puberty，Drug hypersensitivity reaction，Failure to supress hypothalamic pituitary gonadal axis