leuprolide and Abscess

We describe a case of an 8 year old girl with central precocious puberty. She was commenced on 3 monthly intramuscular depot Leuprorelin acetate therapy, as a result of which she developed sterile abscesses. She was converted to daily subcutaneous Leuprorelin acetate therapy with no recurrence of the abscesses. The possible mechanisms for this reaction are described in the article.

Topics: Abscess; Child; Delayed-Action Preparations; Female; Humans; Injections, Intradermal; Leuprolide; Puberty, Precocious

Long-acting forms of gonadotropin-releasing hormone (GnRH) receptor agonists are commonly used for the treatment of central precocious puberty (CPP). Sterile abscess formation has been reported as a complication of leuprolide acetate, but not histrelin acetate.. The aim of this study was to report an adverse drug reaction in a child with sterile abscess formation following treatment with 2 different branded long-acting forms of GnRH agonists.. An otherwise healthy 8-year-old white female (weight, 40.7 kg; height, 140.1 cm) with documented CPP and no known drug allergies developed a sterile abscess at the site of the monthly intramuscular injection of 15 mg of leuprolide acetate. Because of this site reaction, a 50-mg histrelin acetate insert was placed in the patient's left arm. A similar reaction occurred 2 weeks after insert placement on 2 separate occasions in different arms. At the time of the removal of the second insert, Gram stain and swab culture of the purulent wound discharge were negative. The child was subsequently treated with intranasal nafarelin (800 ug twice daily) and tolerated it well. The Naranjo Adverse Drug Reaction Causality Score was 10 (definite, ≥9).. This report describes a case of sterile abscess formation definitely associated with 2 different forms of long-acting GnRH agonist treatment in a child.

Topics: Abscess; Child; Delayed-Action Preparations; Drug Implants; Female; Gonadotropin-Releasing Hormone; Humans; Injections, Intramuscular; Leuprolide; Nafarelin; Puberty, Precocious; Receptors, LHRH

We describe a patient with advanced prostate cancer who failed to achieve testosterone suppression with depot leuprolide after developing sterile abscesses at the injection sites. When the patient was switched to depot goserelin, he did not have any evidence of inflammation at the injection sites, but testosterone suppression again failed. This case suggests variable mechanisms for failure of gonadotropin-releasing hormone agonist therapy and highlights the necessity of prospective testosterone monitoring in patients who have developed sterile abscesses, even if switched to another gonadotropin-releasing hormone agonist.

Topics: Abscess; Adenocarcinoma; Aged; Androgen Antagonists; Anilides; Antineoplastic Agents, Hormonal; Bone Neoplasms; Delayed-Action Preparations; Gonadotropin-Releasing Hormone; Goserelin; Humans; Leuprolide; Male; Nitriles; Orchiectomy; Prostate-Specific Antigen; Prostatic Neoplasms; Testosterone; Tosyl Compounds; Treatment Failure