CEDIE   05498
CENTRO DE INVESTIGACIONES ENDOCRINOLOGICAS "DR. CESAR BERGADA"
Unidad Ejecutora - UE
congresos y reuniones científicas
Título:
Usefulness of serum gonadotropins measure by ultrasensitive assays in boys with doubtfully palpable gonads
Autor/es:
GRINSPON, R.; ROPELATO, M.G.; BEDECARRÁS, P.; REY, R.A.; GOTTLIEB, S.
Lugar:
Viña del Mar, Chile
Reunión:
Congreso; XVIII Reunión anual de la Sociedad Latinoamericana de Endocrinología Pediátrica; 2006
Institución organizadora:
Sociedad Latinoamericana de Endocrinología Pediátrica (SLEP)
Resumen:
Introduction and objectives: Anorchia or hypogonadism should be ruled out in normally virilized boys in whom the presence of testes cannot be clearly ascertained by palpation. AMH and inhibin B are sensitive and specific direct markers of testicular function, yet assays for these hormones may not always be available. Basal testosterone is useful only in 0-6 month-old boys and after pubertal onset. Little attention is often given to LH and FSH levels in childhood. The aim of this study was to determine the value of basal serum gonadotropin levels, measured by ultrasensitive assays, to assess the existence and integrity of testicular tissue. Methodology: We evaluated the levels of FSH and LH (IFMA), AMH (ELISA), and T (RIA) in 60 boys with normal virilization but doubtfully palpable testes. Testicular presence and functional status were defined according to AMH and/or T levels. Results are shown as odds ratio (OR) or predictive values (PV) with 95% confidence interval. Boys with doubtfully palpable gonads and high gonadotropins were at increased risk of anorchia or primary hypogonadism [LH: OR 15.3, PV 100% (69-100%); FSH: OR 24.4 and PV 100 % (77-100%)]. Lack of gonadotropin elevation was predictive of present testes [LH: PV 98% (89-99%), FSH: PV 95% (85-99%)] but did not rule out primary hypogonadism [LH: PV 42% (28-57%), FSH: PV 46% (31-61%)]. Conclusions: in boys with doubtfully palpable gonads, elevated LH and/or FSH are useful to predict hypo/agonadism, but not to differentiate between anorchia and damaged testes. Lack of gonadotropin elevation ascertains the diagnosis of present testes but it is not useful to differentiate between damaged and normo-functional gonads.