Test Catalog

Test Id : LHPED

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Luteinizing Hormone (LH), Pediatrics, Serum

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Overview

Test Catalog

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosis of precocious puberty and delayed puberty in children

Highlights

In children, luteinizing hormone, along with follicle-stimulating hormone, is used to diagnose delayed and precocious (early) puberty.

 

This assay is sensitive to 0.02 IU/L and is more appropriate for use in children.

 

This assay offers a 10-fold increase in analytical sensitivity over existing automated immunoassays.

Method Name
A short description of the method used to perform the test

Chemiluminescent Immunoassay (CIA)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

LH, Pediatrics, S

Aliases
Lists additional common names for a test, as an aid in searching

Third Generation LH assay

Ultrasensitive LH assay

Lutropin

Specimen Type
Describes the specimen type validated for testing

Serum

Ordering Guidance

This test is only available for pediatric patients. If testing request is for a patient 18 years of age or older, order LH / Luteinizing Hormone (LH), Serum.

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Supplies: Sarstedt 5 mL Aliquot Tube (T914)

Collection Container/Tube:

Preferred: Red top

Acceptable: Serum gel

Submission Container/Tube: Plastic vial

Specimen Volume: 0.25 mL

Collection Instructions:

1. Red-top tubes should be centrifuged, and the serum transferred to a plastic vial within 2 hours of collection.

2. Serum gel tubes should be centrifuged within 2 hours of collection.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the testing laboratory. The minimum volume is sufficient for one attempt at testing.

0.13 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis Reject
Gross lipemia Reject
Gross icterus Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
Frozen 90 days

Useful For
Suggests clinical disorders or settings where the test may be helpful

Diagnosis of precocious puberty and delayed puberty in children

Clinical Information
Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Luteinizing hormone (LH) is a glycoprotein hormone consisting of 2 noncovalently bound subunits (alpha and beta). LH is produced by the anterior pituitary gland under regulation of the hypothalamic gonadotropin releasing hormone (GnRH) and feedback from gonadal steroid hormones. In children, LH, along with follicle-stimulating hormone (FSH), is used to diagnose precocious (early) and delayed puberty.

 

Precocious puberty refers to the appearance of physical and hormonal signs of pubertal development at an earlier age than is considered normal (before 8 years of age in girls and 9 years of age in boys). Evaluation of precocious puberty includes measurement of LH and FSH to determine whether gonadotropins are increased in relation to chronologic age (gonadotropin-dependent) or whether sex steroid secretion is occurring independent of LH and FSH (gonadotropin-independent). In gonadotropin-dependent precocious puberty, basal LH levels are often elevated into the pubertal range and show a pubertal (heightened) response to GnRH stimulation. In gonadotropin-independent precocious puberty, the LH level is low at baseline and fails to respond to GnRH stimulation.

 

Delayed puberty is defined clinically by the absence or incomplete development of secondary sexual characteristics by age 14 years in boys and by age 12 years in girls. Delayed puberty usually results from inadequate gonadal steroid secretion that, in turn, is most often caused by a defective gonadotropin secretion from the anterior pituitary, due to defective production of GnRH from the hypothalamus. Random measurements of LH and FSH, together with estradiol (girls) or testosterone (boys), are useful to distinguish between primary and secondary causes of delayed puberty.

Reference Values
Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Females

<1 year: <0.02-18.3 IU/L

1-8 years: <0.02-0.3 IU/L

9-10 years: <0.02-4.8 IU/L

11-13 years: <0.02-11.7 IU/L

14-17 years: <0.02-16.7 IU/L

 

Tanner Stages*

Stage I (1-8 years): <0.02-0.3 IU/L

Stage II: <0.02-4.1 IU/L

Stage IIl: 0.6-7.2 IU/L

Stage IV-V: 0.9-13.3 IU/L

*Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for girls at a median age of 10.5 (+/- 2) years. There is evidence that it may occur up to 1 year earlier in obese girls and in African-American girls. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18.

 

Males

<1 year: <0.02-5.0 IU/L

1-8 years: <0.02-0.5 IU/L

9-10 years: <0.02-3.6 IU/L

11-13 years: 0.1-5.7 IU/L

14-17 years: 0.8-8.7 IU/L

 

Tanner Stages*

Stage I (1-8 years): <0.02-0.5 IU/L

Stage II: 0.03-3.7 IU/L

Stage IIl: 0.09-4.2 IU/L

Stage IV-V: 1.3-9.8 IU/L

*Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for boys at a median age of 11.5 (+/- 2) years. For boys there is no proven relationship between puberty onset and body weight or ethnic origin. Progression through Tanner stages is variable. Tanner stage V (adult) should be reached by age 18.

Interpretation
Provides information to assist in interpretation of the test results

In young children, high levels of luteinizing hormone (LH) and follicle-stimulating hormone (FSH), along with the development of secondary sexual characteristics at an unusually young age, are an indication of gonadotropin-dependent precocious puberty (also called central precocious puberty). Prepubertal levels of LH and FSH in children exhibiting some signs of pubertal changes may be an indication of gonadotropin-independent precocious puberty (also refer as precocious pseudopuberty). In precocious pseudopuberty the signs and symptoms are the result of elevated levels of estrogen in girls or testosterone in boys.

 

In delayed puberty, LH and FSH levels can be normal or below what is expected for a youth within this age range. The test for LH response to gonadotropin releasing hormone in addition to other testing may help to diagnose the reason for the delayed puberty.

Cautions
Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No clinically significant cross-reactivity has been demonstrated with follicle-stimulating hormone, human chorionic gonadotropin, free alpha subunit of pituitary glycoprotein hormones, or free beta subunit of luteinizing hormone. Cross-reactivity with thyrotropin (TSH) (<5%) might be observed at TSH concentrations of 500 mIU/L.

 

Some patients who have been exposed to animal antigens, either in the environment or as part of treatment or imaging procedures, may have circulating anti-animal antibodies present. These antibodies may interfere with the assay reagents to produce unreliable results.

Clinical Reference
Recommendations for in-depth reading of a clinical nature

1. Jameson JL, ed. Reproductive Endocrinology. In: Harrison's Endocrinology. 2nd ed. McGraw-Hill. 2010;144-241

2. Wei C, Davis N, Honour J, Crowne E: The investigation of children and adolescents with abnormalities of pubertal timing. Ann Clin Biochem. 2017 Jan;54(1):20-32

Method Description
Describes how the test is performed and provides a method-specific reference

The AnshLite LH CLIA is a quantitative three-step sandwich type immunoassay. In the first step calibrators, controls, and unknown samples are added to luteinizing hormone (LH) antibody-coated microtiter wells and incubated. After washing, the wells are incubated with biotinylated LH antibody solution. After the second incubation and washing, the wells are incubated with streptavidin horseradish peroxidase conjugate solution. Finally, the antibody-antigen and conjugate complex bound to the well is detected by addition of a luminogenic substrate (AnshLite chemiluminescence substrate solution). The relative light output units are directly proportional to the concentration of LH in the samples.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday, Wednesday, Friday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

2 to 6 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees :
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

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Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

83002

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
LHPED LH, Pediatrics, S 83103-2
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
62999 LH, Pediatrics, S 83103-2

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports