How to check hormone levels in children

The hormone level in a child's body is an important indicator of whether the child is precocious, because many children drink a lot of dairy products, and the hormones in some dairy products can cause children to mature too quickly. Therefore, many parents are afraid that their children may have precocious puberty and will take their children to the hospital for hormone tests. If a child's hormone levels are to be tested, how should they be tested?

What are the six examination criteria for children's sex hormones?

The six hormone tests include:

1. Follicular estrogen (FSH);

2. Luteinizing hormone (LH);

3. Estrogen (E2);

4. Progesterone (P);

5. Androgen (T);

6. Prolactin (PROL). The luteinizing hormone (LH) level is 2-15mIU/ml in the preovulatory period, 30-100mIU/ml in the ovulatory period, 4-10mIU/ml in the postovulatory period, and the normal value in the non-ovulatory period is 5-25mIU/ml. A level lower than 5mIU/ml indicates gonadotropin insufficiency, which is seen in Sheehan's syndrome. If high FSH is accompanied by high LH, ovarian failure is very certain and no other tests are necessary. Follicle-stimulating hormone (FSH) is 2-10mIU/ml in the preovulatory period, 8-20mIU/ml in the ovulatory period, and 2-10mIU/ml in the postovulatory period. Generally, 5 to 40 mIU/ml is considered normal. A level higher than 1 nmol/L is hyperprolactinemia. The level of estradiol (E2) is 48-521 picomoles/liter before ovulation, 70-1835 picomoles/liter during ovulation, and 272-793 picomoles/liter during postovulation. The progesterone (P) blood P concentration is 0-4nmol/L before ovulation and 7-97nmol/L in the late ovulation period. Testosterone (T) The normal concentration of testosterone in female blood is 1-3nmol/L.

What are the differential diagnoses for precocious puberty in children?

Although the GnRH stimulation test can generally distinguish central from peripheral precocious puberty, the following situations should be distinguished:

1. Simple premature breast development

That is, partial central precocious puberty (PICPP). FSH increases significantly after GnRH stimulation (it will also increase after stimulation in normal prepubertal girls), but LH does not increase significantly (mostly L), and FSH/LH>1. However, it is worth noting that PICPP can transform into CPP without any clinical precursor manifestations. Therefore, regular follow-up is required after the diagnosis of PICPP, especially for those with repeated or persistent breast enlargement, and repeated stimulation tests should be performed if necessary.

2. CPP derived from non-central precocious puberty

For example, in cases of congenital adrenal hyperplasia and McCune-Albright syndrome, it is necessary to monitor the occurrence of CPP during the treatment of the primary disease.

3. Precocious puberty associated with congenital hypothyroidism

It is a special type of precocious puberty. The basal level of blood LH in early-stage patients is elevated, but it does not increase after GnRH stimulation. It is transformed into true CPP only after a long course of the disease. Short stature is its main characteristic.