### Title of the Article:

Role of Inhibin B, AMH, GnRHa Test, and HCG Stimulation Test to Distinguish Isolated Hypogonadotropic Hypogonadism (IHH) from Constitutional Delay in Growth and Puberty (CDGP)

First two Authors followed by et al:

Bijay K. Sahoo, Padala Ravi Kumar, et al.

One-line Summary of the Article:

This study evaluates the diagnostic utility of various hormonal tests to differentiate between isolated hypogonadotropic hypogonadism (IHH) and constitutional delay in growth and puberty (CDGP) in children.

Six Key Points from the Article:

  1. Diagnosis Criteria: Delayed puberty is characterized by the absence of testicular enlargement by age 14 in boys and lack of breast development by age 13 in girls.

  2. Study Participants: Included boys (14-18 years) with testicular volume <4 ml and girls (13-18 years) at Tanner B1 stage.

  3. Tests Performed: Hormonal analysis including basal LH, FSH, inhibin B, AMH, testosterone (boys), oestradiol (girls), triptorelin stimulation test, and 3-day HCG stimulation test (boys).

  4. Diagnostic Utility: 4-hour post-triptorelin LH showed 100% sensitivity and specificity for IHH in both sexes; basal inhibin B had high sensitivity and specificity for diagnosing IHH.

  5. Key Findings: Post-triptorelin 4-hour LH and inhibin B are reliable tests for distinguishing IHH from CDGP; basal LH, FSH, and AMH were poor discriminators.

  6. Follow-up Results: Over a follow-up period of 1.5 years, 21 children were diagnosed with CDGP and 13 with IHH, with distinct hormonal profiles aiding diagnosis.

Practical Take Home Message:

The post-triptorelin 4-hour LH test and basal inhibin B levels are effective in distinguishing IHH from CDGP, providing a reliable approach for timely and accurate diagnosis in clinical settings.

Citation for the Article in Vancouver Format:

Sahoo BK, Ravi Kumar P, Pattanaik SR, Dash DK, Patro D, Telagareddy R. Role of inhibin B, AMH, GnRHa test and HCG stimulation test to distinguish isolated hypogonadotropic hypogonadism (IHH) from constitutional delay in growth and puberty (CDGP). Indian J Endocr Metab. 2024;28:153-9.