The 24-hour urinary excretion of luteinizing hormone (LH) and follicle stimulating hormone (FSH) was determined for 30 days in an 8.3-year-old girl with isosexual precocity and for 25 days in a normal 11.9-year-old girl. The pattern of daily variation in urinary LH and FSH excretion observed in the girl with sexual precocity was similar to that of the normal menstrual cycle. The LH and FSH midcycle peaks were 132.5 IU/24 hours and 26.3 IU/24 hours, respectively. Excluding the midcycle peak, the daily excretion of LH was 28.4 +/- 9.3 (SD) IU/24 hours, and the excretion of FSH was 8.9 +/- 1.9 (SD) IU/24 hours, values comparable to those of normal adult females. In contrast, the daily excretion of LH in the normal 11.9-year-old girl was 6.9 +/- 1.1 (SD) IU/24 hours and FSH excretion was 3.9 +/- 0.9 (SD) IU/24 hours. No LH or FSH surge was observed. The data are consistent with early maturation of the hypothalamic-pituitary-gonadal axis in idiopathic isosexual precocity.

Child↗

PubMedDate not supplied

Cell free serum interleukin-2 receptor levels after heart transplantation.

The aim of this study was to predict episodes of rejection or infection in heart transplant recipients by monitoring serum interleukin-2 receptor (IL-2R) levels, rather than by endomyocardial biopsy. The shedding of IL-2R from activated lymphocytes results in increased serum interleukin-2 levels and is probably a result of immune activation occurring in both rejection and infection processes. As a group, heart transplant recipients who had no rejection of infection had significantly increased serum IL-2R levels compared with healthy controls. Patients who had moderate and severe rejection, and infection, had significantly increased serum IL-2R levels compared with levels in patients without rejection or infection. High serum IL-2R levels were seen mainly within the first 3 months after transplantation. Of 15 patients studied, nine had consistent increases in serum IL-2R levels with episodes of rejection or infection. Serum IL-2R levels did not correlate with serum cyclosporine levels. The monitoring of serum IL-2R levels was not a sensitive test of rejection because increases were not seen in all episodes of rejection; increases were seen, however, in all cases of infection. This test lacked specificity as serum IL-2R levels increased during episodes of both rejection and infection. In conclusion, the monitoring of serum IL-2R levels may be a useful way to routinely monitor or screen for possible rejection infection in heart transplant recipients, but this method should not replace endomyocardial biopsy for diagnosing rejection.

Graft Rejection↗