leuprolide and Headache

We evaluated the pituitary and gonadal suppression in 40 girls and nine boys treated with depot leuprorelin (3.75 mg sc if body weight > or = 20 kg, 1.87 mg if body weight < 20 kg) every 28 days for central precocious puberty. Gonadal suppression was obtained in most of the children with this dose: 3 months after initiation of the treatment, 85% of children had a peak plasma luteinizing hormone response to gonadotropin-releasing hormone < 3 IU/l and the gonadal axis remained suppressed throughout the duration of the study (up to 24 months). Four patients required higher doses of leuprorelin to achieve suppression. In two girls, a cutaneous reaction to the drug was associated with incomplete suppression and the treatment had to be interrupted. Plasma leuprorelin levels tended to increase from day 3 to day 28 after injection. Residual leuprorelin levels measured 28 days after injection were stable during the first year of the study. We conclude that an initial dose of depot leuprorelin of 3.75 mg sc every 28 days is efficient in most children with central precocious puberty.

Topics: Bone Development; Child; Delayed-Action Preparations; Drug Eruptions; Drug Tolerance; Female; Gonadotropin-Releasing Hormone; Growth; Headache; Humans; Leuprolide; Luteinizing Hormone; Male; Puberty, Precocious

Gonadotropin-releasing hormone agonists, used widely in the treatment of metastatic prostate cancer and hormone receptor-positive breast cancer, are associated with a rare but potentially fatal outcome of pituitary apoplexy (PA). An 85-year-old man presented with sudden onset of headache, left eye pain, sensitivity to light, nausea and vomiting. The symptoms started 4 hours after initiation of leuprolide therapy for treatment of recently diagnosed metastatic prostate carcinoma. Radiological imaging of the brain demonstrated a heterogeneously enlarged pituitary gland measuring 19×16×13 mm and T1-hyperintense signal compatible with pituitary haemorrhage. Hormone function tests were indicative of panhypopituitarism, confirming the diagnosis of PA. Due to age, the patient was started on hormonal replacement therapy and eventually symptoms improved.

Topics: Aged, 80 and over; Antineoplastic Agents, Hormonal; Diagnosis, Differential; Headache; Humans; Leuprolide; Magnetic Resonance Imaging; Male; Pituitary Apoplexy; Prostatic Neoplasms

Topics: Adult; Antineoplastic Agents, Hormonal; Baths; Endometriosis; Female; Headache; Hot Temperature; Humans; Leuprolide

Recurring periods of prolonged erections in patients with sickle cell disease (stutter priapism) are uncommon, yet troubling sequelae of hemoglobinopathies. Medical or surgical therapy is variably successful in these men. We report a case of stutter priapism successfully treated with an oral antiandrogen.

Topics: Adult; Androgen Antagonists; Anemia, Sickle Cell; Flutamide; Gynecomastia; Headache; Humans; Leuprolide; Male; Mastectomy; Priapism; Radiotherapy; Treatment Outcome

One hundred two premenopausal women with uterine myomas were treated with LA depot. All women experienced adverse effects during GnRH-a treatment. The majority experienced symptoms attributed to a rapid and sustained decrease in circulating estrogen concentrations beginning 2 to 7 weeks after initiation of treatment. A smaller percentage of women experienced transient adverse effects due to the initial surge and subsequent rapid decline of gonadal steroids. The mechanism of other adverse effects (e.g., arthralgias) remains unclear. Only 6% of women terminated LA treatment before 12 weeks because of the severity of adverse effects.

Topics: Adult; Delayed-Action Preparations; Estradiol; Estrogens; Female; Flushing; Headache; Humans; Leuprolide; Middle Aged; Osmolar Concentration; Retrospective Studies