184 METOCLOPRAMIDE TEST DIFFERENTIATES HYPOGONADOTROPIC HYPOGONADISM FROM DELAYED PUBERTY

Abstract

To evaluate whether metoclopramide-releasable prolactin response had diagnostic values in the differentiation between hypogonadotropic hypogonadism (HH) and constitutional delay of puberty (D) the serum responses of prolactin, LH and FSH to metoclopramide-GnRH were studied in 9 boys with HH, 7 boys with D and 15 controls. Metoclopramide increased prolactin levels in all groups (Table).

Table. Basal and maximal prolactin levels (mIU/1).

In the boys with HH, the maximal serum levels of prolactin were completely separate from the levels of the controls. Nevertheless, the maximal levels of prolactin were subnormal (=below the 90% confidence ranges of the controls) in 8/9 boys with HH. All the boys with D had normal maximal levels of prolactin. The maximal levels of LH were subnormal in only 3/9 boys and those of FSH in 0/9 boys with HH. Metoclopramide test appears to be effective in further improving the differentiation of HH and D.