A simplified procedure for evaluatingestrogenic effects and the sex chromatin pattern in exfoliated cells in urine: Studies in premature thelarche and gynecomastia of adolescence

Collett-Solberg, Pedro R.; Grumbach, Melvin M.

doi:10.1016/s0022-3476(65)80063-4

Cited by 42 publications

(9 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The aetiology of premature thelarche has been variously attributed to increased sensitivity of breast tissue to low levels of oestrogens secreted during childhood19 20 or to increased ovarian oestrogen secretion.2' 22 To support the theory that it is due to increased ovarian oestrogen secretion, high levels of serum oestradiol have been found by some investigators4 8 and these have been attributed to increased gonadotrophins.5 Graafian follicles of the ovary have been noted in the newborn and young infant, and it was suggested that they were the source of the oestrogen.23 24 The follicles are thought to be the result of increased concentrations of gonadotrophin since birth.5 6 Others have proposed that there is an increase in the biologically active oestrogen because the unbound fraction is increased in the presence of normal total serum oestrogen. The increase in free oestradiol would result from a presumed decrease in sex hormone-binding globulin.9 Urinary-free oestradiol excretion has not been measured and this might be of interest in further studies.…”

Section: Discussionmentioning

confidence: 99%

Premature thelarche: a possible adrenal disorder.

Dumić¹,

Tajić²,

Mardesić³

et al. 1982

Archives of Disease in Childhood

View full text Add to dashboard Cite

SUMMARY Endocrine studies in girls with precocious thelarche were compared with those of normal girls of similar ages. Girls with precocious thelarche showed breast development and oestrogenised vaginal smears as the only signs of precocious sexual development. A few of the girls were tall and some had advanced bone ages but these two findings were not consistently present in the same patient. Hormones-such as serum oestradiol, oestrone, A 4-androstenedione, progesterone, dehydroepiandrosterone (DHEA), follicle-stimulating hormone, luteinising hormone, and prolactin, and urinary 17-ketosteroids-were measured. Only DHEA was different, being higher in girls with precocious thelarche. It is suggested that the high DHEA level may serve as a precursor for conversion to oestrogens in the target tissues, breast, and vagina. This mechanism for oestrogenisation has been reported in other patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Premature thelarche: a possible adrenal disorder.

Dumić¹,

Tajić²,

Mardesić³

et al. 1982

Archives of Disease in Childhood

View full text Add to dashboard Cite

show abstract

“…Several lines of evidence now indicate that the pituitary-ovarian axis is active during midchildhood. Luteinizing hormone (LH) and folliclestimulating hormone (FSH) are detectable in blood and urine by both bioassay and immunoassay [16,17], Appar ently in response to gonadotropin stimulation, antral folli cle formation increases during childhood according to both histologic and ultrasonographic assessment [18,19], Furthermore, estrogen secretion is occasionally detected both by bioassay (genitourinary tract cytology) and immu noassay [20,21], GnRH testing suggests that the normal prepubertal pattern of gonadotropin synthesis is one of FSH predominance, that FSH predominance increases in early puberty ( fig. 3), and that increasing LH responsive ness coincides with pubertal progression in girls [22], GnRH agonist testing gives similar results [23,24], with the possible exception that the author's group found no change in FSH responsiveness in early puberty, perhaps because the assay used detected different molecular spe cies of FSH than other assays.…”

Section: Premature Thelarche As a Variant Of Normalmentioning

confidence: 99%

Normal and Almost Normal Precocious Variations in Pubertal Development Premature Pubarche and Premature Thelarche Revisited

Rosenfield¹

1994

Horm Res

View full text Add to dashboard Cite

Premature pubarche, premature thelarche and complete precocious puberty are usually simply normal phenomena occurring at an early age. This is not necessarily the case, however, and they may sometimes be harbingers of reproductive endocrine disturbances in adulthood. Consequently, girls with these complaints cannot be entirely reassured that they are of no consequence, and they should be followed to ascertain whether pubertal reproductive function is eventually normal.

show abstract

“…A predominance of superficial cells in the neonatal vaginal mucosa was noted as early as 1938 [23]; and, in the 1960s, superficial cells in urinary sediment were shown to decrease with increasing age in infancy and to rise with the onset of puberty in both males and females [12,13]. Clinically, a small study of children with endocrine-related disorders observed that 8 of 9 cases of premature thelarche (age 14-32 months) and 7 of 8 cases of gynecomastia (age 12-15 years) had ≥ 5% superficial cells in cells collected from urinary sediment, compared to 1 of 8 and 7 healthy control subjects, respectively [21]. …”

Section: Discussionmentioning

confidence: 99%

“…Sensitivity and specificity were calculated by treating “newborn” status as the gold-standard outcome. A score of ≥5% superficial cells was taken as the test’s informative cutpoint, on the basis of clinical observations reported by Collett-Solberg and Grumbach [21]. Analyses were completed using SAS 9.3 (SAS Institute Inc., Cary, NC).…”

Section: Methodsmentioning

confidence: 99%

Urogenital Epithelial Cells as Simple Markers of Estrogen Response in Infants: Methods and Applications

et al. 2013

View full text Add to dashboard Cite

Exposure to estrogen-mimicking chemicals during critical periods of development, such as infancy, may have adverse effects. However, these effects can be difficult to characterize in most epidemiologic studies. For example, growth of reproductive organs may be susceptible to estrogenic chemicals, but measuring it requires skilled ultrasound examination; timing of pubertal onset may be altered, but observing it requires long-term follow up. To address the need for a simple marker of response to estrogenic exposures in infants, we propose a novel application of a classic marker of estrogen response in adult women: cytological evaluation of urogenital epithelial cells. In this cross-sectional study of 34 female and 41 male infants, we demonstrate that epithelial cells can be obtained from swabs of the vaginal introitus (females) and urethral meatus (males), as well as from spun urine, and that these cells respond to differential estrogenic conditions, as indicated by the relative abundance of the superficial epithelial cell type. To model varying estrogen exposure, we sampled from infants who were either newborn (highly exposed to maternal estrogens), or 12 weeks old (12W) (negligibly exposed to estrogen). Newborns had a higher percentage of superficial cells (%S), as compared to 12W (mean ± standard error: 8.3 ± 1.8 vs. 0.9 ± 0.2) (p < 0.01), consistent with an estrogen response. This difference in %S from newborn to 12W was observed similarly for swab (-7.6 ± 1.7) and urine (-7.3 ± 2.6) specimens and for males (-9.6 ± 2.9) and females (-5.2 ± 2.1). Examination of urogenital epithelial cells can successfully demonstrate estrogen response in both sexes, using cell specimens collected from either swab or urine sampling. In future studies, this simple, non-invasive method may be applied to assess whether estrogen-mimicking chemicals produce an estrogenic response in infants.

show abstract

A simplified procedure for evaluatingestrogenic effects and the sex chromatin pattern in exfoliated cells in urine: Studies in premature thelarche and gynecomastia of adolescence

Cited by 42 publications

References 24 publications

Premature thelarche: a possible adrenal disorder.

Premature thelarche: a possible adrenal disorder.

Normal and Almost Normal Precocious Variations in Pubertal Development Premature Pubarche and Premature Thelarche Revisited

Urogenital Epithelial Cells as Simple Markers of Estrogen Response in Infants: Methods and Applications

Contact Info

Product

Resources

About