Gonadotrophin-dependent precocious puberty (GDPP) is a rare condition, more common in
girls, in which occurs the development of secondary sexual characters at inappropriate age,
associated with the acceleration of growth, as well as bone age, drastically impairing height the
child's ultimate goal. Treatment with gonadotrophin releasing hormone (aGnRH) analogues for
bone age stabilization is well established in the literature, especially in cases of early diagnoses
and treatment is started before the age of six years. Objective: The present study aimed to
evaluate if the associated use of growth hormone (rGH) was superior to the isolated use of
aGnRH in relation to improving predicted height. Method: Retrospective longitudinal study of
patients’ medical records with precocious puberty dependent on gonadotropins attended at the
endocrinology clinic of the University Hospital João de Barros Barreto. After clinical,
laboratory or imaging diagnosis of GDPP, the patients were divided into two groups according
to the type of treatment they underwent, and the data was analyzed descriptively and
analytically. Results: The group treated with aGnRH and rGH combination (n = 27) was
smaller than the group treated with aGnRH alone (n = 88), however, in the associated treatment
group, the proportion of boys was higher (29%) when compared to the group with only
analogues (5%). In addition, these patients had a lower bone age increase with a mean height
increase of 14.1 cm over a 2-year follow-up versus 11.1 cm in the aGnRH group alone in the
same period. In addition, the predicted height in the rGH + aGnRH group increased
significantly by an average of 7.4 cm in 2 years of treatment, while the group in use of the
isolated analog also improved, but only 3.7 cm after 2 years of pubertal block. Conclusion:
Both the treatment with the isolated analogue and in combination with growth hormone were
beneficial to improve the predicted height, but in the group with associated drugs, a greater
benefit was observed, even in patients who started treatment late, Thus, despite the high cost
and the need for further studies, the use of growth hormone should be considered at least in
patients with late diagnosis of precocious gonadotrophin-dependent puberty.
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