Triptorelin-Induced Delayed Transient Arterial Hypertension: A Case Series with Review of Literature

Background: Gonadotropin-releasing hormone analogs (GnRHas) such as triptorelin have been found to be effective and safe in the suppression of central precocious puberty (CPP). Only minor and transient side effects have been reported with depot preparation used in children. Clinical Description: We present three children with CPP who developed late onset hypertension 18–24 months after starting triptorelin, a long-acting GnRHa depot preparation. The secondary causes of hypertension were ruled out on the basis of clinical findings, appropriate blood tests, echocardiography, and abdominal ultrasound. Management and Outcome: After starting therapy with GnRHa, the children were evaluated routinely every 2–3 months for the 1st year, then every 6 months. They developed hypertension between 18 and 24 months after starting triptorelin. While therapy with triptorelin was stopped in all three children, only one of them was prescribed antihypertensive drug. The hypertension resolved gradually after discontinuation of triptorelin in all the children and antihypertensive was also omitted in the single case. Conclusion: Hypertension may be an adverse effect of triptorelin therapy and thus regular monitoring of blood pressure in children undergoing therapy with this drug for CPP is warranted.