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[Effect of intranasal administration of an LH-RH analog on basal gonadotropin concentrations and stimulation in patients with hypogonadotropic hypogonadism].

The effect of intranasal administration of the LHRH analogue D-Leu-6-des Gly-10 NH2EA on gonadotropin (Gn) stimulation was studied in 8 juvenile patients with ascertained hypogonadotropic hypogonadism, due to multiple pituitary deficiencies (MPD) in 5 cases and the Prader-Willi syndrome (PWS) in the remaining 3 patients. A bolus LHRH test was performed before and after a treatment period lasting between 2 and 5 weeks. In 2 MPD patients there was a transient rise in basal LH concentrations and a slight improvement in the second LHRH test; hence a hypothalamic lesion is assumed. In the other MPD patients there was no change in Gn stimulation. The sex steroid levels remained low. Gn stimulation was improved in all 3 patients with PWS after LHRH administration and in one 19-year-old boy the onset of puberty was probably induced by this therapy. However, after continuous administration of the analogue the initially increased Gn levels decreased again. In view of this inhibiting action on Gn levels the LHRH analogue does not appear suitable for the long-term treatment of hypogonadotropic hypogonadism.